| Wilburton Family Dentistry, Llc | |
|
114 W Main St Wilburton OK 74578-4044 | |
| (918) 465-2381 | |
| Not Available |
| Full Name | Wilburton Family Dentistry, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 114 W Main St, Wilburton, Oklahoma |
| Authorized Official Name and Position | Casey Osterhout (PRESIDENT) |
| Authorized Official Contact | 9184653535 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wilburton Family Dentistry, Llc 114 W Main St Wilburton OK 74578-4044 Ph: (918) 465-2381 | Wilburton Family Dentistry, Llc 114 W Main St Wilburton OK 74578-4044 Ph: (918) 465-2381 |
| NPI Number | 1518099357 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518099357 | NPI | - | NPPES |
| 1073676862 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5805 (Oklahoma) | Primary |