Muskogee Pediatric Dental Pllc

NPI #1265198410 in Muskogee, Oklahoma

Provider Information

NPI Number: 1265198410
Entity Type: Organization
Organization Name: Muskogee Pediatric Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Nov 11, 2021
Last Updated: Nov 11, 2021

Practice Location

Address: 930 W SHAWNEE ST
City: Muskogee
State: Oklahoma
ZIP Code: 74401-3511
Phone: (918) 998-0996

Authorized Official

Name: ANNE DEMMY
Title: CREDENTIALING SPECIALIST
Phone: (918) 998-0996

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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