Dental Depot 62nd & South Western Pllc
NPI #1003196239 in Oklahoma City, Oklahoma
Provider Information
- NPI Number
- 1003196239
- Entity Type
- Organization
- Organization Name
- Dental Depot 62nd & South Western Pllc
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 19, 2011
- Last Updated
- Jun 25, 2021
Practice Location
- Address
- 6217 S WESTERN AVE
- City
- Oklahoma City
- State
- Oklahoma
- ZIP Code
- 73139-1605
- Phone
- (405) 606-7123
Authorized Official
- Name
- DR. GLENN ALLEN ASHMORE, DDS
- Title
- PRESIDENT
- Phone
- (405) 949-0123
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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