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General NPI Number Information
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NPI Number | 1497159164
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Entity Type | Organization
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Legal Business Name | WESLEY DUFFEL DDS FAMILY DENTISTRY PLLC
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 1205 S MUSTANG RD
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City | YUKON
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State | OK
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Zip | 73099-9355
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Country | US
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Telephone | 405-577-6999
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Fax |
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Provider Business Mailing Address
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Address Line | 1205 S MUSTANG RD
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City | YUKON
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State | OK
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Zip | 73099-9355
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Country | US
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Telephone | 405-577-6999
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. WESLEY AARON DUFFEL
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Credential | D.D.S
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Telephone | 405-577-6999
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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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