Provider Demographics
NPI:1861402372
Name:BUGG, CHRISTOPHER RYAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:RYAN
Last Name:BUGG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E. BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-3432
Mailing Address - Country:US
Mailing Address - Phone:918-285-5500
Mailing Address - Fax:918-285-5502
Practice Address - Street 1:601 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-3432
Practice Address - Country:US
Practice Address - Phone:918-285-5500
Practice Address - Fax:918-285-5502
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK56281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice