Dental Professionals of Oklahoma, PC

NPI #1649000605 in Moore, Oklahoma

Provider Information

NPI Number: 1649000605
Entity Type: Organization
Organization Name: Dental Professionals of Oklahoma, PC
Subpart: Yes (part of a larger organization)
Parent Organization: DENTAL PROFESSIONALS OF OKLAHOMA, PC
Primary Specialty: Dentist
Enumeration Date: Aug 5, 2024
Last Updated: Aug 5, 2024

Practice Location

Address: 711 SW 19TH ST STE 100
City: Moore
State: Oklahoma
ZIP Code: 73160-2966
Phone: (405) 913-7622

Authorized Official

Name: CEMYIRA MCDOUGAL
Title: CREDENTIALING COORDINATOR
Phone: (217) 764-8609

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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