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General NPI Number Information
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NPI Number | 1134387731
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Entity Type | Organization
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Legal Business Name | CLINT METCALF, D.D.S., PC
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Dates
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Enumeration Date | 05/30/2008
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Last Update Date | 02/26/2018
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Provider Practice Location Address
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Address Line | 1325 S. SANGRE ROAD
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City | STILLWATER
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State | OK
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Zip | 74074
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Country | US
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Telephone | 405-624-0222
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Fax | 405-624-6003
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Provider Business Mailing Address
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Address Line | 1325 S. SANGRE ROAD
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City | STILLWATER
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State | OK
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Zip | 74074
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Country | US
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Telephone | 405-624-0222
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Fax | 405-624-6003
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Authorized Official
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Title or Position | CEO
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Name | DR. CLINT T METCALF
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Credential | DDS
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Telephone | 405-624-0222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5649
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License Number State | OK
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