Dental Professionals of Oklahoma, P.c.

NPI #1548557002 in Yukon, Oklahoma

Provider Information

NPI Number: 1548557002
Entity Type: Organization
Organization Name: Dental Professionals of Oklahoma, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: DENTAL PROFESSIONALS OF OKLAHOMA, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 6, 2011
Last Updated: Sep 15, 2015

Practice Location

Address: 1670 GARTH BROOKS BLVD
Address 2: SUITE 115
City: Yukon
State: Oklahoma
ZIP Code: 73099-6878
Phone: (405) 494-3080

Authorized Official

Name: HEATHER N. PRUEMER
Title: CREDENTIALING COORDINATOR
Phone: (217) 540-8434

Specialties & Taxonomy Codes

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

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