Jefferson Orthodontics Ok PLLC
Dentist, Orthodontics and Dentofacial Orthopedics in Oklahoma City, OK. Organization (NPI-2).
NPI number1235802414
StatusActive
Last updated in NPPESJul 26, 2021
Details
- NPI
- 1235802414
- Entity type
- Organization (NPI-2)
- Legal business name
- Jefferson Orthodontics Ok PLLC
- Organization subpart
- No
- Enumeration date
- Jul 26, 2021
- Certification date
- Jul 26, 2021
- Last updated
- Jul 26, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223X0400X | Dentist, Orthodontics and Dentofacial Orthopedics | – | – | Yes |
Practice location
3625 Nw 39th StOklahoma City, OK 73112-6309
Phone 405-669-2580
Mailing address
3030 Lbj Fwy Ste 1400Dallas, TX 75234-2766
Phone 972-444-8888
Authorized official
Ankoo Raina
President
9724448888
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