# DENTAL CARE OF MUSKOGEE, INC.

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

## Provider details

- **NPI number:** 1154544187
- **Authorized official:** DR. JONAS CHRISTOPHER MCCALL D.D.S. (D.D.S.)
- **Authorized official phone:** (918) 682-5518

## Contact information

- **Practice address:** 2406 E. SHAWNEE AVENUE, SUITE D, MUSKOGEE, OK 74403-1561
- **Practice address phone:** (918) 682-5518
- **Practice address fax:** (918) 683-0410
- **Mailing address:** 2406 E. SHAWNEE AVENUE, SUITE D, MUSKOGEE, OK 74403-1561
- **Mailing address phone:** (918) 682-5518
- **Mailing address fax:** (918) 683-0410

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 5961 | OK | Yes |
| 1223G0001X | General Practice Dentistry | 4047 | OK | — |

## Other

- **Enumeration date:** 04/10/2007
- **Last updated:** 04/01/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100054210A | — | OK |
| 05 | — | 200030980A | — | OK |