NPI Code Details Logo

NPI 1932076189

NPI 1932076189 : ATOKA FAMILY DENTAL PLLC : ATOKA, OK

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1932076189
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    ATOKA FAMILY DENTAL PLLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/22/2025
-----------------------------------------------------
    Last Update Date     |    11/12/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    203 E COURT ST 
-----------------------------------------------------
    City                 |    ATOKA
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    74525-2045
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    405-930-4100
-----------------------------------------------------
    Fax                  |    405-669-8675
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    851 W I 35 FRONTAGE RD STE 350 
-----------------------------------------------------
    City                 |    EDMOND
-----------------------------------------------------
    State                |    OK
-----------------------------------------------------
    Zip                  |    73034-7472
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    405-930-4100
-----------------------------------------------------
    Fax                  |    405-669-8675
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CEO ENHANCE DENTAL
-----------------------------------------------------
    Name                 |     BENJAMIN  BOWMAN 
-----------------------------------------------------
    Credential           |    DDS
-----------------------------------------------------
    Telephone            |    405-930-4100
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QD0000X
-----------------------------------------------------
    Taxonomy Name        |    Dental Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.