Healthcare Provider Details

I. General information

NPI: 1982288874
Provider Name (Legal Business Name): LFD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8470 NW EXPRESSWAY
OKLAHOMA CITY OK
73162-6009
US

IV. Provider business mailing address

8470 NW EXPRESSWAY
OKLAHOMA CITY OK
73162-6009
US

V. Phone/Fax

Practice location:
  • Phone: 405-445-4016
  • Fax:
Mailing address:
  • Phone: 405-728-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA BRASHER
Title or Position: DENTIST
Credential: DDS
Phone: 405-445-4016