# DENTAL ARTS OF LOCUST GROVE, LLC

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

## Provider details

- **NPI number:** 1083499123
- **Authorized official:** SOREN MICHAELSEN DDS (OWNER)
- **Authorized official phone:** (405) 593-9596

## Contact information

- **Practice address:** 409 E MAIN ST, LOCUST GROVE, OK 74352-5116
- **Practice address phone:** (918) 888-5055
- **Mailing address:** PO BOX 549, LOCUST GROVE, OK 74352-0549
- **Mailing address phone:** (918) 888-5055

## Taxonomy

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

## Other

- **Enumeration date:** 08/28/2023
- **Last updated:** 08/28/2023