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37D2089428 CLIA NUMBER - WAGONER FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 37D2089428

Facility Name: WAGONER FAMILY PRACTICE

Facility Address:
1202 WEST CHEROKEE, STE E ATTN KATIE SAMPSON
WAGONER, OK
ZIP 74467
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Facility Phone Number: 918 485-1877

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1821276817

Taxonomy: 122300000X - Dentist
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

CLIA Record

Field Name Field Value
CLIA Number 37D2089428
LAB Type Physician Office
Facility Name WAGONER FAMILY PRACTICE
Street 1202 WEST CHEROKEE, STE E ATTN KATIE SAMPSON
City WAGONER
State OK
ZIP 74467
Phone 918 485-1877
CertificateType 4
CertificateEffectiveDate 12/30/2022
CertificateExpirationDate 12/29/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024