Provider Demographics
NPI:1366672552
Name:LAWTON SURGICAL AND COSMETIC ARTS
Entity Type:Organization
Organization Name:LAWTON SURGICAL AND COSMETIC ARTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:CLOYCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:LITTLEFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-357-0888
Mailing Address - Street 1:3617 W GORE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6373
Mailing Address - Country:US
Mailing Address - Phone:580-357-0888
Mailing Address - Fax:580-248-1860
Practice Address - Street 1:3617 W GORE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-6373
Practice Address - Country:US
Practice Address - Phone:580-357-0888
Practice Address - Fax:580-248-1860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-22
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty