Healthcare Provider Details

I. General information

NPI: 1720051477
Provider Name (Legal Business Name): AARON R. MEANS SR. D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2006
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HERITAGE CIRCLE
PAWNEE OK
74058-4839
US

IV. Provider business mailing address

1201 HERTIAGE CIRCLE
PAWNEE OK
74058
US

V. Phone/Fax

Practice location:
  • Phone: 918-762-6561
  • Fax: 918-762-3456
Mailing address:
  • Phone: 918-423-2456
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number10164
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: