Provider Demographics
NPI:1306003694
Name:DR SUE BETH ABER DDS PC
Entity Type:Organization
Organization Name:DR SUE BETH ABER DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:ABER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS PC
Authorized Official - Phone:918-423-0091
Mailing Address - Street 1:320 S 4TH
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501
Mailing Address - Country:US
Mailing Address - Phone:918-423-0091
Mailing Address - Fax:918-423-0348
Practice Address - Street 1:320 S 4TH
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501
Practice Address - Country:US
Practice Address - Phone:918-423-0091
Practice Address - Fax:918-423-0348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK52681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty