Provider Demographics
NPI:1124239801
Name:DEBRA A. EATON
Entity type:Organization
Organization Name:DEBRA A. EATON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:EATON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-224-6581
Mailing Address - Street 1:228 W CHICKASHA AVE
Mailing Address - Street 2:SUITE 503
Mailing Address - City:CHICKASHA
Mailing Address - State:OK
Mailing Address - Zip Code:73018-2669
Mailing Address - Country:US
Mailing Address - Phone:405-224-6581
Mailing Address - Fax:405-224-3292
Practice Address - Street 1:228 W CHICKASHA AVE
Practice Address - Street 2:SUITE 503
Practice Address - City:CHICKASHA
Practice Address - State:OK
Practice Address - Zip Code:73018-2669
Practice Address - Country:US
Practice Address - Phone:405-224-6581
Practice Address - Fax:405-224-3292
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5479122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty