Organization · Type 2 NPI
Custom Dental of Yukon, PLLC
Dental Clinic/Center · Yukon, OK
NPI number
1164049185
Active
Practice location
4425 Grant Blvd
Yukon, OK 73099
Fax (405) 494-4184
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | None listed |
Dental Clinic/Center: Definition to come...
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About NPI 1164049185
Custom Dental of Yukon, PLLC's National Provider Identifier is 1164049185, issued on Jun 26, 2020. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Yukon, OK. The record was last updated on Jun 26, 2020.