Organization · NPI-2

Dental Care Of Muskogee, INC.

Dentist · Muskogee, OK

NPI number1154544187
StatusActive
Last updated in NPPESApr 1, 2011

Details

NPI
1154544187
Entity type
Organization (NPI-2)
Legal business name
Dental Care Of Muskogee, INC.
Organization subpart
No
Enumeration date
Apr 10, 2007
Last updated
Apr 1, 2011

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist5961OKYes
1223G0001X Dentist, General Practice4047OK

Practice location

2406 E. Shawnee Avenue
Suite D
Muskogee, OK 74403-1561

Phone 918-682-5518 · Fax 918-683-0410

Mailing address

2406 E. Shawnee Avenue
Suite D
Muskogee, OK 74403-1561

Phone 918-682-5518 · Fax 918-683-0410

Authorized official

Jonas Christopher Mccall
D.D.S.
9186825518

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