Organization · NPI-2

Alva Dental Studio PLLC

Dentist, General Practice · Tulsa, OK

NPI number1417609447
StatusActive
Last updated in NPPESDec 19, 2022

Details

NPI
1417609447
Entity type
Organization (NPI-2)
Legal business name
Alva Dental Studio PLLC
Organization subpart
No
Enumeration date
Jan 20, 2022
Certification date
Dec 19, 2022
Last updated
Dec 19, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice––Yes
261QD0000X Clinic/Center, Dental––

Other names

  • Tulsa Sculpted Smiles (Doing Business As)

Practice location

4415 S Harvard Ave Ste 102
Tulsa, OK 74135-2616

Phone 918-742-2096

Mailing address

4415 S Harvard Ave Ste 102
Tulsa, OK 74135-2616

Phone 918-742-2096

Authorized official

Joshua Vernon Brasher
Owner/Mbr
4054746362

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