Organization · NPI-2

59th Street Dental Health Center, P.C.

Dentist, General Practice · Oklahoma City, OK

NPI number1306257696
StatusActive
Last updated in NPPESMay 8, 2014

Details

NPI
1306257696
Entity type
Organization (NPI-2)
Legal business name
59th Street Dental Health Center, P.C.
Organization subpart
No
Enumeration date
May 8, 2014
Last updated
May 8, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice6574OKYes

Other names

  • Abc Dental (Doing Business As)

Practice location

309 Sw 59th St Ste 105
Oklahoma City, OK 73109-8322

Phone 405-631-2700

Mailing address

309 Sw 59th St Ste 105
Oklahoma City, OK 73109-8322

Authorized official

Travis Boyer
Owner
4056312700

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