Provider Demographics
NPI:1720426091
Name:HARPER, RICKIE LEE (RDH)
Entity Type:Individual
Prefix:MISS
First Name:RICKIE
Middle Name:LEE
Last Name:HARPER
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12136 S YUKON AVE
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-6621
Mailing Address - Country:US
Mailing Address - Phone:918-216-1000
Mailing Address - Fax:
Practice Address - Street 1:12136 S YUKON AVE
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-6621
Practice Address - Country:US
Practice Address - Phone:918-216-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-10
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3636124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist