Organization · Type 2 NPI

Custom Dental of Edmond, PLLC

General Practice Dentistry · Oklahoma City, OK

NPI number 1013211846 Active

Practice location

17840 N. Penn
Oklahoma City, OK 73012

Call (405) 282-6440 Map

Fax (405) 282-6785

Mailing address

17840 N Pennsylvania Ave
Edmond, OK 73012-9097

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X5978 (OK)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1013211846

Custom Dental of Edmond, PLLC's National Provider Identifier is 1013211846, issued on Jan 10, 2011. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Oklahoma City, OK. The record was last updated on Sep 15, 2011.