Provider Demographics
NPI:1083883706
Name:MICHAEL E. AITSON DDS INC. PC
Entity Type:Organization
Organization Name:MICHAEL E. AITSON DDS INC. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:ELLIOTT
Authorized Official - Last Name:AITSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-254-0039
Mailing Address - Street 1:1020 18TH STREET
Mailing Address - Street 2:
Mailing Address - City:WOODWARD
Mailing Address - State:OK
Mailing Address - Zip Code:73801-2902
Mailing Address - Country:US
Mailing Address - Phone:580-254-0039
Mailing Address - Fax:580-254-2080
Practice Address - Street 1:1020 18TH STREET
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-2902
Practice Address - Country:US
Practice Address - Phone:580-254-0039
Practice Address - Fax:580-254-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental