Modern Dental Professionals - Oklahoma, PC

NPI #1306186796 in Moore, Oklahoma

Provider Information

NPI Number: 1306186796
Entity Type: Organization
Organization Name: Modern Dental Professionals - Oklahoma, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Feb 21, 2013
Last Updated: Mar 1, 2013

Practice Location

Address: 711 SW 19TH STREET
Address 2: SUITE 100
City: Moore
State: Oklahoma
ZIP Code: 73160
Phone: (972) 212-8135

Authorized Official

Name: PAUL PEEK, DDS
Title: PC OWNER/DENTIST
Phone: (972) 212-8135

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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