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General NPI Number Information
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NPI Number | 1063359693
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Entity Type | Organization
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Legal Business Name | ON THE CUSP STILLWATER, PLLC
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Dates
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Enumeration Date | 05/01/2026
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 1405 S SANGRE RD
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City | STILLWATER
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State | OK
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Zip | 74074-1832
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Country | US
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Telephone | 918-970-4944
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Fax | 918-970-4953
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Provider Business Mailing Address
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Address Line | 8222 E 103RD ST STE 133
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City | TULSA
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State | OK
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Zip | 74133-7027
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Country | US
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Telephone | 918-970-4944
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Fax | 918-970-4953
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DR. RYAN ROBERTS
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Credential | DDS,MS
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Telephone | 918-970-4944
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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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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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