# DIAMOND DENTAL, PLLC

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

## Provider details

- **NPI number:** 1184181760
- **Authorized official:** AMANDA LIGHTFOOT (AUTHORIZED REPRESENTATIVE)
- **Authorized official phone:** (214) 702-0708

## Contact information

- **Practice address:** 1991 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-6225
- **Practice address phone:** (405) 737-6622
- **Mailing address:** 15660 DALLAS PKWY STE 925, DALLAS, TX 75248-3323
- **Mailing address phone:** (214) 702-0729

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 03/01/2019
- **Last updated:** 05/08/2023