| Talihina Family Dentistry | |
|
200 Dallas St Talihina OK 74571-2402 | |
| (918) 567-3961 | |
| (918) 567-3424 |
| Full Name | Talihina Family Dentistry |
|---|---|
| Speciality | Dentist |
| Location | 200 Dallas St, Talihina, Oklahoma |
| Authorized Official Name and Position | Ramon L Lake (PRESIDENT R L LAKE DDS INC) |
| Authorized Official Contact | 9185673961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Talihina Family Dentistry 200 Dallas St Talihina OK 74571-2402 Ph: (918) 567-3961 | Talihina Family Dentistry 200 Dallas St Talihina OK 74571-2402 Ph: (918) 567-3961 |
| NPI Number | 1669585402 |
|---|---|
| Provider Enumeration Date | 08/16/2006 |
| Last Update Date | 09/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669585402 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4059 (Oklahoma) | Primary |
Talihina Family Dentistry Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Dallas St, Talihina, OK 74571 Phone: 918-567-3961 Fax: 918-567-3424 |