Organization · NPI-2

240 Dg PLLC

Dentist, General Practice · Oklahoma City, OK

NPI number1184492977
StatusActive
Last updated in NPPESDec 12, 2023

Details

NPI
1184492977
Entity type
Organization (NPI-2)
Legal business name
240 Dg PLLC
Organization subpart
No
Enumeration date
Dec 12, 2023
Certification date
Dec 12, 2023
Last updated
Dec 12, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice––Yes

Practice location

7200 S Pennsylvania Ave Ste B
Oklahoma City, OK 73159-3336

Phone 405-681-6668

Mailing address

7200 S Pennsylvania Ave Ste B
Oklahoma City, OK 73159-3336

Phone 405-681-6668

Authorized official

Joshua Brasher
Member
4052502255

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