Fagan, Randy J

Fagan, Randy J is an individual health care provider with primary practice located at 2221 W Washington St , Broken Arrow OK 74012-6726. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Fagan, Randy J can be contacted via phone (918) 455-6406.

Contact Information

Primary practice address
2221 W Washington St Broken Arrow OK 74012-6726
Phone: (918) 455-6406
Fax: (918) 455-1856
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 5318 Oklahoma

Profile Details

NPI number 1487628731
LBN Legal business name Fagan, Randy J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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