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General NPI Number Information
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NPI Number | 1023475118
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Entity Type | Organization
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Legal Business Name | KAW NATION
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Dates
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Enumeration Date | 01/21/2016
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Last Update Date | 01/21/2016
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Provider Practice Location Address
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Address Line | 3151 E. RIVER RD
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City | NEWKIRK
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State | OK
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Zip | 74647
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Country | US
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Telephone | 580-362-1944
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Fax | 580-362-2988
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Provider Business Mailing Address
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Address Line | 3151 E. RIVER RD
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City | NEWKIRK
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State | OK
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Zip | 74647
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Country | US
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Telephone | 580-362-1944
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Fax | 580-362-2988
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Authorized Official
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Title or Position | KAW NATION CHAIR
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Name | MRS. ELAINE HUCH
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Credential |
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Telephone | 580-269-2552
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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