| Dentrust Oklahoma, Pc | |
|
Bldg 1712 Macomb Rd Ft.still OK 73503-4533 | |
| (267) 927-5000 | |
| (267) 927-5000 |
| Full Name | Dentrust Oklahoma, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | Bldg 1712, Ft.still, Oklahoma |
| Authorized Official Name and Position | Amanda Clark (CREDENTIALING) |
| Authorized Official Contact | 8134514503 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dentrust Oklahoma, Pc 6097 Easton Rd Pipersville PA 18947-1810 Ph: (267) 927-5000 | Dentrust Oklahoma, Pc Bldg 1712 Macomb Rd Ft.still OK 73503-4533 Ph: (267) 927-5000 |
| NPI Number | 1518598267 |
|---|---|
| Provider Enumeration Date | 01/31/2020 |
| Last Update Date | 01/31/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518598267 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |