| NPI | 1437958196 |
|---|---|
| Doing Business As | EDMOND PEDIATRIC AND TEEN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE V DASCH Director Of Cred And Prov Rel 615-678-0759 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-03-13 |
| Last Update Date | 2025-03-13 |