Provider Demographics
NPI:1629363817
Name:F PHILIP ARCHER DDS PLLC
Entity Type:Organization
Organization Name:F PHILIP ARCHER DDS PLLC
Other - Org Name:F PHILIP ARCHER DDS PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRONT OFFICE
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAYNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GIVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-938-6161
Mailing Address - Street 1:9224 S TOLEDO CT
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-2743
Mailing Address - Country:US
Mailing Address - Phone:918-938-6161
Mailing Address - Fax:918-492-7379
Practice Address - Street 1:9224 S TOLEDO CT
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2743
Practice Address - Country:US
Practice Address - Phone:918-938-6161
Practice Address - Fax:918-492-7379
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-15
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK34221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty