| Oklahoma Restorative | |
|
1943 W 33rd St Ste 100 Edmond OK 73013-3910 | |
| (405) 906-3345 | |
| (405) 906-3426 |
| Full Name | Oklahoma Restorative |
|---|---|
| Speciality | Clinic/center |
| Location | 1943 W 33rd St Ste 100, Edmond, Oklahoma |
| Authorized Official Name and Position | Melinda Valls Mackey (OWNER) |
| Authorized Official Contact | 4059063345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oklahoma Restorative 1943 W 33rd St Ste 100 Edmond OK 73013-3910 Ph: (405) 906-3345 | Oklahoma Restorative 1943 W 33rd St Ste 100 Edmond OK 73013-3910 Ph: (405) 906-3345 |
| NPI Number | 1841042660 |
|---|---|
| Provider Enumeration Date | 04/04/2024 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841042660 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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