Provider Demographics
NPI:1124171780
Name:CHANCELLOR, DOUGLAS CRANSTON (DDS)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:CRANSTON
Last Name:CHANCELLOR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:4440 NW EXPRESSWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1533
Mailing Address - Country:US
Mailing Address - Phone:405-843-3600
Mailing Address - Fax:405-843-3667
Practice Address - Street 1:3727 NW 63RD ST
Practice Address - Street 2:SUITE 112
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1931
Practice Address - Country:US
Practice Address - Phone:405-843-3600
Practice Address - Fax:405-843-3667
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2013-09-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK44041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice