| Emerson Orthodontics | |
|
800 W Mission St Broken Arrow OK 74012-2599 | |
| (918) 459-0092 | |
| (918) 455-0270 |
| Full Name | Emerson Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 800 W Mission St, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Clinton Wade Emerson (MANAGER) |
| Authorized Official Contact | 9184590092 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Emerson Orthodontics 800 W Mission St Broken Arrow OK 74012-2599 Ph: (918) 459-0092 | Emerson Orthodontics 800 W Mission St Broken Arrow OK 74012-2599 Ph: (918) 459-0092 |
| NPI Number | 1083815377 |
|---|---|
| Provider Enumeration Date | 05/31/2007 |
| Last Update Date | 12/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083815377 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | ORTHO SPECIALTY #153 (Oklahoma) | Primary |
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