| Organization Name: | RUSSELL E. COATNEY, D.D.S. , P.C. |
| NPI Number: | 1003083593 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RUSSELL ERIC COATNEY (PRESIDENT/OWNER) |
| Mailing Address: | 110 S Date Ave Jenks |
| State: | OK US |
| Postal Code: | 740373742 |
| Phone Number: | 9182994477 |
| Fax Number: | 9182990827 |
| NPI Enumeration Date: | 05/13/2008 |
| NPI Last Update Date: | 05/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QD0000X |
| License Number: | 4686 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Dental |
| Taxonomy Definition: | |