| Lavalley Dental Care, Inc. | |
|
300 E Highway St Holdenville OK 74848-4060 | |
| (405) 379-2700 | |
| Not Available |
| Full Name | Lavalley Dental Care, Inc. |
|---|---|
| Speciality | Dentist |
| Location | 300 E Highway St, Holdenville, Oklahoma |
| Authorized Official Name and Position | Renee Lynnette Lavalley (PRESIDENT) |
| Authorized Official Contact | 4053792700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavalley Dental Care, Inc. 300 E Highway St Holdenville OK 74848-4060 Ph: (405) 379-2700 | Lavalley Dental Care, Inc. 300 E Highway St Holdenville OK 74848-4060 Ph: (405) 379-2700 |
| NPI Number | 1740455674 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 04/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740455674 | NPI | - | NPPES |
| 100097210A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 5172 (Oklahoma) | Primary |
Phil Tyree Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N Hinckley St, Holdenville, OK 74848 Phone: 405-379-6695 Fax: 405-379-6923 |