Eastern Oklahoma Oral and Maxillofacial Surgeons
NPI #1487074704 in Broken Arrow, Oklahoma
Provider Information
- NPI Number
- 1487074704
- Entity Type
- Organization
- Organization Name
- Eastern Oklahoma Oral and Maxillofacial Surgeons
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Enumeration Date
- Apr 25, 2014
- Last Updated
- Mar 17, 2018
Practice Location
- Address
- 4716 W URBANA ST
- City
- Broken Arrow
- State
- Oklahoma
- ZIP Code
- 74012-5997
- Phone
- (918) 449-5800
Authorized Official
- Name
- MS. ANGIE ROE
- Title
- CREDENTIALING AND CONTRACTING
- Phone
- (888) 247-1869
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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