Healthcare Provider Details

I. General information

NPI: 1558467753
Provider Name (Legal Business Name): JAMES F OWENS DDS MS PC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 W WASHINGTON
BROKEN ARROW OK
74012-6450
US

IV. Provider business mailing address

425 W WASHINGTON
BROKEN ARROW OK
74012-6450
US

V. Phone/Fax

Practice location:
  • Phone: 918-455-7700
  • Fax: 918-455-5541
Mailing address:
  • Phone: 918-455-7700
  • Fax: 918-455-5541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number3993
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: