# MEDICAL CONSULTANT SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** 00000000
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1033560966
- **Legal business name:** 00000000
- **Authorized official:** DR. MANSOOR BHATTI DDS, PHD, PA-C (DIRECTOR OF CLINICAL MEDICINE)
- **Authorized official phone:** (419) 819-9498

## Contact information

- **Practice address:** 3309 W PRINCETON ST, BROKEN ARROW, OK 74012-9587
- **Practice address phone:** (419) 819-9498
- **Mailing address:** 3309 W PRINCETON ST, BROKEN ARROW, OK 74012-9587
- **Mailing address phone:** (419) 819-9498

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |

## Other

- **Enumeration date:** 06/22/2016
- **Last updated:** 06/23/2016