| Nova Oral Surgery Llc | |
|
803 N Monte Vista St Ada OK 74820-7711 | |
| (580) 332-3010 | |
| (580) 332-3010 |
| Full Name | Nova Oral Surgery Llc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 803 N Monte Vista St, Ada, Oklahoma |
| Authorized Official Name and Position | Hans Charles Igou (OWNER) |
| Authorized Official Contact | 5803323010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nova Oral Surgery Llc 803 N Monte Vista St Ada OK 74820-7711 Ph: (580) 332-3010 | Nova Oral Surgery Llc 803 N Monte Vista St Ada OK 74820-7711 Ph: (580) 332-3010 |
| NPI Number | 1225747736 |
|---|---|
| Provider Enumeration Date | 11/23/2022 |
| Last Update Date | 11/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225747736 | NPI | - | NPPES |
| 200485650A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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