Healthcare Provider Details
I. General information
NPI: 1851314280
Provider Name (Legal Business Name): R. DON JAMES D.D.S. INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/26/2006
Last Update Date: 09/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3621 NW 63RD ST STE B
OKLAHOMA CITY OK
73116-2041
US
IV. Provider business mailing address
3621 NW 63RD ST., SUITEB
OKLAHOMA CITY OK
73116-2041
US
V. Phone/Fax
- Phone: 405-848-2884
- Fax: 405-848-3249
- Phone: 405-848-2884
- Fax: 405-848-3249
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | 3272 |
| License Number State | OK |
VIII. Authorized Official
Name: DR.
RICHARD
DON
JAMES
Title or Position: PRESIDENT/ORTHODONTIST
Credential: D.D.S., M.S.D.
Phone: 405-848-2884