Dental Depot Orthodontics Moore, Pllc

NPI #1205649282 in Moore, Oklahoma

Provider Information

NPI Number: 1205649282
Entity Type: Organization
Organization Name: Dental Depot Orthodontics Moore, Pllc
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Jan 31, 2025
Last Updated: Jan 31, 2025

Practice Location

Address: 2709 S I 35 FRONTAGE RD STE A
City: Moore
State: Oklahoma
ZIP Code: 73160-2715
Phone: (405) 957-5440

Authorized Official

Name: GAYLON ZISSA
Title: DIRECTOR OF PROVIDER RELATIONS
Phone: (405) 945-8941

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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