Ollie Logan Beard IV, DDS
Dentist in Tishomingo, OK. Individual provider (NPI-1).
NPI number1992233779
StatusActive
Last updated in NPPESMay 24, 2017
Details
- NPI
- 1992233779
- Entity type
- Individual (NPI-1)
- Name
- Ollie Logan Beard IV
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 24, 2017
- Last updated
- May 24, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 6918 | OK | Yes |
Practice location
610 E 24th StTishomingo, OK 73460-3245
Phone 580-371-2343 · Fax 580-371-2451
Mailing address
Po Box 128Madill, OK 73446-0128
Phone 580-795-6664
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All 13 Dentist providers in Tishomingo · All 289 providers in Tishomingo
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