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General NPI Number Information
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NPI Number | 1356590954
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Entity Type | Organization
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Legal Business Name | DR. RICHARD C. CANADY, D.D.S.
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Dates
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Enumeration Date | 09/18/2008
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Last Update Date | 09/18/2008
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Provider Practice Location Address
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Address Line | 6116 E 61ST ST
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City | TULSA
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State | OK
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Zip | 74136-2117
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Country | US
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Telephone | 918-523-9200
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Fax | 918-523-9212
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Provider Business Mailing Address
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Address Line | 6116 E 61ST ST
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City | TULSA
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State | OK
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Zip | 74136-2117
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Country | US
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Telephone | 918-523-9200
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Fax | 918-523-9212
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Authorized Official
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Title or Position | FRONT OFFICE COORDINATOR
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Name | MICHELLE MCALISTER
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Credential |
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Telephone | 918-523-9200
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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 |
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License Number State |
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