Provider Demographics
NPI:1962669044
Name:CONTEMPORARY FAMILY DENTISTRY, P.C.
Entity Type:Organization
Organization Name:CONTEMPORARY FAMILY DENTISTRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
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:405-387-9300
Mailing Address - Street 1:1117 NW 32ND ST
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:OK
Mailing Address - Zip Code:73065-6326
Mailing Address - Country:US
Mailing Address - Phone:405-387-9300
Mailing Address - Fax:405-387-9398
Practice Address - Street 1:1117 NW 32ND ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:OK
Practice Address - Zip Code:73065-6326
Practice Address - Country:US
Practice Address - Phone:405-387-9300
Practice Address - Fax:405-387-9398
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-17
Last Update Date:2008-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK58571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty