Provider Demographics
NPI:1336481977
Name:AYERS FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:AYERS FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:AYERS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-485-6080
Mailing Address - Street 1:1019 N COUNCIL AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:BLANCHARD
Mailing Address - State:OK
Mailing Address - Zip Code:73010-8046
Mailing Address - Country:US
Mailing Address - Phone:405-485-6080
Mailing Address - Fax:405-485-6089
Practice Address - Street 1:1019 N COUNCIL AVE STE 2
Practice Address - Street 2:
Practice Address - City:BLANCHARD
Practice Address - State:OK
Practice Address - Zip Code:73010-8046
Practice Address - Country:US
Practice Address - Phone:405-485-6080
Practice Address - Fax:405-485-6089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2013-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty