Provider Demographics
NPI:1083710727
Name:WARD, ANNIECE (DDS)
Entity Type:Individual
Prefix:
First Name:ANNIECE
Middle Name:
Last Name:WARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 SHORT STOP WAY
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-5503
Mailing Address - Country:US
Mailing Address - Phone:773-301-0644
Mailing Address - Fax:
Practice Address - Street 1:2920 SHORT STOP WAY
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-5503
Practice Address - Country:US
Practice Address - Phone:773-301-0644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0271641223G0001X
OK6663122300000X
TX26135122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice