Provider Demographics
NPI:1831130640
Name:MCANEAR, GARRICK OLEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARRICK
Middle Name:OLEN
Last Name:MCANEAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7829 W HEFNER RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-4301
Mailing Address - Country:US
Mailing Address - Phone:405-603-4662
Mailing Address - Fax:405-603-5562
Practice Address - Street 1:7829 W HEFNER RD
Practice Address - Street 2:SUITE B
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73162-4301
Practice Address - Country:US
Practice Address - Phone:405-603-4662
Practice Address - Fax:405-603-5562
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK56111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice