| Complete Cosmetic Care Dentistry | |
|
12136 S Yukon Ave Sapulpa OK 74066-6621 | |
| (918) 216-1000 | |
| (918) 216-1100 |
| Full Name | Complete Cosmetic Care Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 12136 S Yukon Ave, Sapulpa, Oklahoma |
| Authorized Official Name and Position | Sandy Salamandra (OFFICE MANAGER) |
| Authorized Official Contact | 9182161000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Cosmetic Care Dentistry 12136 S Yukon Ave Sapulpa OK 74066-6621 Ph: (918) 216-1000 | Complete Cosmetic Care Dentistry 12136 S Yukon Ave Sapulpa OK 74066-6621 Ph: (918) 216-1000 |
| NPI Number | 1053740563 |
|---|---|
| Provider Enumeration Date | 11/05/2013 |
| Last Update Date | 11/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053740563 | NPI | - | NPPES |
| 200201950A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6032 (Oklahoma) | Primary |
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