Provider Demographics
NPI:1073622189
Name:TEMPLETON, CHRISTOPHER KENNY IV (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:KENNY
Last Name:TEMPLETON
Suffix:IV
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:125 E 3RD ST STE A
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-3822
Mailing Address - Country:US
Mailing Address - Phone:405-216-3735
Mailing Address - Fax:405-216-5363
Practice Address - Street 1:125 E 3RD ST STE A
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73034-3822
Practice Address - Country:US
Practice Address - Phone:405-216-3735
Practice Address - Fax:405-216-5363
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2020-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50871223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery