Provider Demographics
NPI:1376771196
Name:VINCENT, SHYLER DEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHYLER
Middle Name:DEE
Last Name:VINCENT
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 1:509 TRINIDAD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5143
Mailing Address - Country:US
Mailing Address - Phone:405-206-8913
Mailing Address - Fax:405-701-1724
Practice Address - Street 1:1201 NORTH STONEWALL
Practice Address - Street 2:UNIV. OF OK COLLEGE OF DENTISTRY, AEGD
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73126-0901
Practice Address - Country:US
Practice Address - Phone:405-271-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-01
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6116122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist