# DDSI SOUTH AEC LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** DDSI South AEC LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043253263
- **Authorized official:** DIANA J MOCK (DIRECTOR)
- **Authorized official phone:** (405) 767-6630

## Contact information

- **Practice address:** 4201 SOUTH WESTERN, STE. 4000, OKLAHOMA CITY, OK 73109-3410
- **Practice address phone:** (405) 632-4000
- **Practice address fax:** (405) 632-4073
- **Mailing address:** 4201 S WESTERN AVE, OKLAHOMA CITY, OK 73109-3410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 0075 | OK | Yes |

## Other

- **Enumeration date:** 06/14/2006
- **Last updated:** 02/10/2021