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General NPI Number Information
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NPI Number | 1972764470
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Entity Type | Organization
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Legal Business Name | STEPHEN M. BUCHANAN, D.D.S.
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Dates
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Enumeration Date | 06/18/2008
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Last Update Date | 06/18/2008
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Provider Practice Location Address
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Address Line | 3001 NW 63RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3603
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Country | US
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Telephone | 405-840-7714
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 NW 63RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73116-3603
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Country | US
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Telephone | 405-840-7714
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CANDICE NICOLE ST.CYR
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Credential |
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Telephone | 405-840-7714
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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 | 5067
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License Number State | OK
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