Varsity Dental PLLC
Dentist, General Practice in Norman, OK. Organization (NPI-2).
NPI number1295325512
StatusActive
Last updated in NPPESJan 20, 2021
Details
- NPI
- 1295325512
- Entity type
- Organization (NPI-2)
- Legal business name
- Varsity Dental PLLC
- Organization subpart
- No
- Enumeration date
- Jan 20, 2021
- Certification date
- Jan 20, 2021
- Last updated
- Jan 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Practice location
509 S Porter AveNorman, OK 73071-5437
Phone 405-321-4060
Mailing address
509 S Porter AveNorman, OK 73071-5437
Phone 405-321-4060
Authorized official
Joshua Brasher
President
4053590808
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