Provider Demographics
NPI:1043267545
Name:DUGAN DENTAL, INC.
Entity type:Organization
Organization Name:DUGAN DENTAL, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:D.
Authorized Official - Middle Name:COLEY
Authorized Official - Last Name:DUGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-732-8999
Mailing Address - Street 1:8827 E RENO AVE
Mailing Address - Street 2:SUITE #202
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-7732
Mailing Address - Country:US
Mailing Address - Phone:405-732-8999
Mailing Address - Fax:
Practice Address - Street 1:8827 E RENO AVE
Practice Address - Street 2:SUITE #202
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-7732
Practice Address - Country:US
Practice Address - Phone:405-732-8999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK51681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty