Dental Depot of Piedmont, Pllc

NPI #1801609896 in Yukon, Oklahoma

Provider Information

NPI Number: 1801609896
Entity Type: Organization
Organization Name: Dental Depot of Piedmont, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 31, 2025
Last Updated: Jan 31, 2025

Practice Location

Address: 11401 NW EXPRESSWAY
City: Yukon
State: Oklahoma
ZIP Code: 73099-8721
Phone: (405) 754-1906

Authorized Official

Name: GAYLON ZISSA
Title: DIRECTOR OF PROVIDER RELATIONS
Phone: (405) 945-8941

Specialties & Taxonomy Codes

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

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