# OK OMS SPECIALTY DENTAL SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** OK OMS SPECIALTY DENTAL SERVICES
- **Other names:** Wisdom Teeth OKC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1164276572
- **Legal business name:** OK OMS SPECIALTY DENTAL SERVICES
- **Authorized official:** CHARLOTTE DASCH (DIRECTOR OF CREDENTIALING &PR)
- **Authorized official phone:** (504) 638-0303

## Contact information

- **Practice address:** 5940 NW EXPRESSWAY, STE 150, OKLAHOMA CITY, OK 73132
- **Practice address phone:** (405) 495-5600
- **Mailing address:** 1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
- **Mailing address phone:** (504) 638-0303

## 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:** 04/12/2024
- **Last updated:** 04/12/2024