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General NPI Number Information
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NPI Number | 1558488817
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Entity Type | Individual
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Provider Name | CHAD MATTHEW GARRISON DDS
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Gender | Male
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 225 N ELM ST
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City | OOLOGAH
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State | OK
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Zip | 74053-6245
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Country | US
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Telephone | 918-443-9900
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Fax | 918-443-9911
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Provider Business Mailing Address
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Address Line | PO BOX 639
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City | OOLOGAH
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State | OK
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Zip | 74053-0639
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Country | US
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Telephone | 918-443-9900
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Fax | 918-443-9911
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 5278
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License Number State | OK
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