Canadian Valley Dentistry PLLC

Organization Active NPI Dental Clinic/Center · El Reno, OK

NPI 1720437296 · NPPES record last updated Jul 12, 2021

Key facts

NPI
1720437296
Entity type
Organization (NPI type 2)
Primary specialty
Dental Clinic/Center 261QD0000X
License
6815 (OK)
Legal business name
CANADIAN VALLEY DENTISTRY PLLC
Practice address
705 Eagle Circle
El Reno, OK 73036-2150
Phone
(405) 262-6677
Fax
(405) 262-1235
NPI assigned
Jun 6, 2016
Organization subpart
No

Authorized official

Name
Dr. Ray Dean Tate, D.D.S.
Title
Dentist
Phone
(405) 262-6677

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

705 Eagle Cir
El Reno, OK 73036
Phone (405) 262-6677

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X
Dental Clinic/Center 261QD0000X 6815 OK Yes

Addresses

Primary practice location

705 Eagle Circle
El Reno, OK 73036-2150

Mailing address

705 Eagle Circle
El Reno, OK 73036-2150
Phone (405) 262-6677

Other providers in El Reno, OK

All providers in El Reno, OK · Dental Clinic/Center in Oklahoma

Sources for this page

Verify at the official NPI Registry.