Provider Demographics
NPI:1295932655
Name:CHASER, MISTY ELAINE (DDS)
Entity type:Individual
Prefix:DR
First Name:MISTY
Middle Name:ELAINE
Last Name:CHASER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MISTY
Other - Middle Name:ELAINE
Other - Last Name:BRIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2620 NW EXPRESSWAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7281
Mailing Address - Country:US
Mailing Address - Phone:405-943-0123
Mailing Address - Fax:405-945-0234
Practice Address - Street 1:2620 NW EXPRESSWAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-943-0123
Practice Address - Fax:405-945-0234
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2018-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5943122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist