# SPRING DENTAL HENRYETTA, PLLC

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

## Provider details

- **NPI number:** 1033774575
- **Authorized official:** RENEE MCBAY (CREDENTIALING MANAGER)
- **Authorized official phone:** (918) 998-0996

## Contact information

- **Practice address:** 202 S 6TH ST, HENRYETTA, OK 74437-5002
- **Practice address phone:** (918) 652-4404
- **Mailing address:** 400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
- **Mailing address phone:** (918) 998-0996

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/09/2019
- **Last updated:** 02/18/2020