| Jay W. Pettit Dds Inc. | |
|
112 N Elm St Bristow OK 74010-2424 | |
| (918) 367-5900 | |
| (918) 367-3226 |
| Full Name | Jay W. Pettit Dds Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 112 N Elm St, Bristow, Oklahoma |
| Authorized Official Name and Position | Jay Wade Pettit (PRESIDENT) |
| Authorized Official Contact | 9183675900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jay W. Pettit Dds Inc. 112 N Elm St Bristow OK 74010-2424 Ph: (918) 367-5900 | Jay W. Pettit Dds Inc. 112 N Elm St Bristow OK 74010-2424 Ph: (918) 367-5900 |
| NPI Number | 1164585097 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164585097 | NPI | - | NPPES |
| 1304885 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4885 (Oklahoma) | Primary |
Corwin Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 221 E 7th Ave, Bristow, OK 74010 Phone: 918-367-3290 | |
Bristow Dental Designs Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 N Main, Bristow, OK 74010 Phone: 918-367-3361 Fax: 918-367-7076 | |
Bristow Dental Designs, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 121 N Main St, Bristow, OK 74010 Phone: 918-367-3361 |