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Organization
MEDICAL CONSULTANT SERVICES
Active
Organization
MEDICAL CONSULTANT SERVICES
Active
Parent organization
00000000
Organization subpart
Yes
Provider details
NPI number
Legal business name
00000000
Authorized official
DR. MANSOOR BHATTI DDS, PHD, PA-C (DIRECTOR OF CLINICAL MEDICINE)
(419) 819-9498
Entity
Organization
Contact information
Practice address
3309 W PRINCETON ST, BROKEN ARROW, OK 74012-9587
(419) 819-9498
Mailing address
3309 W PRINCETON ST, BROKEN ARROW, OK 74012-9587
(419) 819-9498
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
06/22/2016
Last updated
06/23/2016
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