| Sooner Smiles | |
|
3391 Classen Blvd Norman OK 73071-1505 | |
| (405) 321-2414 | |
| (405) 321-3835 |
| Full Name | Sooner Smiles |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3391 Classen Blvd, Norman, Oklahoma |
| Authorized Official Name and Position | Lori Cruz Holden (OWNER) |
| Authorized Official Contact | 4053212414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sooner Smiles 3391 Classen Blvd Norman OK 73071-1505 Ph: (405) 321-2414 | Sooner Smiles 3391 Classen Blvd Norman OK 73071-1505 Ph: (405) 321-2414 |
| NPI Number | 1649444555 |
|---|---|
| Provider Enumeration Date | 04/22/2008 |
| Last Update Date | 06/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649444555 | NPI | - | NPPES |
| 200089410A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5786 (Oklahoma) | Primary |
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