Provider Demographics
NPI:1356354179
Name:DUNCAN, TWANA (DDS)
Entity type:Individual
Prefix:DR
First Name:TWANA
Middle Name:
Last Name:DUNCAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:TWANA
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:107 NE F ST
Mailing Address - Street 2:
Mailing Address - City:ANTLERS
Mailing Address - State:OK
Mailing Address - Zip Code:74523-2603
Mailing Address - Country:US
Mailing Address - Phone:580-298-5581
Mailing Address - Fax:580-298-3310
Practice Address - Street 1:107 NE F ST
Practice Address - Street 2:
Practice Address - City:ANTLERS
Practice Address - State:OK
Practice Address - Zip Code:74523-2603
Practice Address - Country:US
Practice Address - Phone:580-298-5581
Practice Address - Fax:580-298-3310
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100188750AMedicaid
OK796050OtherUNITED CONCORDIA ID
OK100846880AMedicaid
OK73-1499597OtherTAX ID NUMBER