Dental Depot of Broken Arrow, Pllc

NPI #1780001636 in Broken Arrow, Oklahoma

Provider Information

NPI Number
1780001636
Entity Type
Organization
Organization Name
Dental Depot of Broken Arrow, Pllc
Primary Specialty
Dentist
Enumeration Date
Mar 27, 2014
Last Updated
Jun 22, 2021

Practice Location

Address
1950 W KENOSHA ST
ZIP Code
74012-8944
Phone
(405) 945-8941

Authorized Official

Name
DR. GLENN ALLAN ASHMORE, DDS
Title
OWNER / PRESIDENT
Phone
(405) 949-0123

Specialties & Taxonomy Codes

Specialty
Dentist

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