| NPI | 1689331753 |
|---|---|
| Doing Business As | CHILDREN'S DENTISTRY OF COFFEE CREEK |
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FERGUSON Owner 405-562-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2021-11-23 |