Summer Dental Moore Pllc

NPI #1578056065 in Moore, Oklahoma

Provider Information

NPI Number: 1578056065
Entity Type: Organization
Organization Name: Summer Dental Moore Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jun 11, 2018
Last Updated: Jun 11, 2018

Practice Location

Address: 811 SW 19TH ST STE A
City: Moore
State: Oklahoma
ZIP Code: 73160-2890
Phone: (405) 703-5161

Authorized Official

Name: RENEE MCBAY
Title: CREDENTIALING SPECIALIST
Phone: (918) 998-0996

Specialties & Taxonomy Codes

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

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