29TH Street Dental Care

Organization Active NPI General Practice Dentistry · Chickasha, OK

NPI 1912450842 · NPPES record last updated Jul 27, 2016

Key facts

NPI
1912450842
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
29TH STREET DENTAL CARE
Practice address
2900 W Grand Ave
Chickasha, OK 73018-5112
Phone
(405) 222-0222
Fax
(405) 222-0210
NPI assigned
Jul 27, 2016
Organization subpart
No

Authorized official

Name
Dr. John C Phillips III, D.D.S.
Title
Owner
Phone
(405) 222-0222

Practitioners 5

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

National Provider Directory

Locations

2900 W Grand Ave
Chickasha, OK 73018
Phone (405) 222-0222

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

2900 W Grand Ave
Chickasha, OK 73018-5112

Mailing address

2900 W Grand Ave
Chickasha, OK 73018-5112
Phone (405) 222-0222

Other providers in Chickasha, OK

All providers in Chickasha, OK · General Practice Dentistry in Oklahoma

Sources for this page

Verify at the official NPI Registry.