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General NPI Number Information
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NPI Number | 1457765208
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Entity Type | Organization
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Legal Business Name | RBMWC, LLC
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 06/19/2014
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Provider Practice Location Address
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Address Line | 101 N DOUGLAS BLVD STE T
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City | MIDWEST CITY
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State | OK
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Zip | 73130-3329
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Country | US
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Telephone | 405-888-5379
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Fax |
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Provider Business Mailing Address
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Address Line | 101 N DOUGLAS BLVD STE T
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City | MIDWEST CITY
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State | OK
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Zip | 73130-3329
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Country | US
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Telephone | 405-888-5379
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Fax |
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Authorized Official
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Title or Position | REGIONAL MANAGER
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Name | MS. ANGELA LOYD
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Credential |
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Telephone | 405-888-5379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6111
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License Number State | OK
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