South Sooner Dental Partners

NPI #1316458383 in Moore, Oklahoma

Provider Information

NPI Number: 1316458383
Entity Type: Organization
Organization Name: South Sooner Dental Partners
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 18, 2017
Last Updated: Sep 7, 2018

Practice Location

Address: 1060 SW 4TH ST STE 200
City: Moore
State: Oklahoma
ZIP Code: 73160
Phone: (405) 384-7071

Authorized Official

Name: TANNER PRESCOTT, DMD
Title: DOCTOR
Phone: (405) 384-7071

Specialties & Taxonomy Codes

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

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