# SOUTHERN SMILES DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033508312
- **Authorized official:** DR. JAYCEE STARR VAN HORN 6412 (OWNER/DENTIST)
- **Authorized official phone:** (580) 284-8142

## Contact information

- **Practice address:** 8816 S PENNSYLVANIA AVE, SUITE 300, OKLAHOMA CITY, OK 73159-5232
- **Practice address phone:** (405) 682-4665
- **Practice address fax:** (405) 682-0667
- **Mailing address:** 8816 S PENNSYLVANIA AVE, SUITE 300, OKLAHOMA CITY, OK 73159-5232
- **Mailing address phone:** (405) 682-4665
- **Mailing address fax:** (405) 682-0667

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 6412 | OK | Yes |

## Other

- **Enumeration date:** 01/09/2015
- **Last updated:** 01/09/2015