Custom Dental of Cushing,PLLC
Organization Active NPI Dentist · Cushing, OK
NPI 1609140755 · NPPES record last updated Mar 6, 2012
Key facts
- NPI
- 1609140755
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 5997 (OK)
- Legal business name
- CUSTOM DENTAL OF CUSHING,PLLC
- Practice address
- 3200 E. Main Street
Cushing, OK 74023 - Phone
- (405) 343-2737
- NPI assigned
- Mar 6, 2012
- Organization subpart
- No
Authorized official
- Name
- Dan Messer, DDS
- Title
- Dentist
- Phone
- (405) 343-2737
National Provider Directory
Locations
3200 E Main St
Cushing, OK 74023
Phone (405) 343-2737
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 5997 | OK | Yes |
Addresses
Primary practice location
3200 E. Main Street
Cushing, OK 74023
Mailing address
3200 E. Main Street
Cushing, OK 74023
Phone (405) 343-2737
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200346500A | Medicaid | OK |
Other providers in Cushing, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.