# VIC H. TRAMMELL DMD, PC

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

## Provider details

- **NPI number:** 1265756308
- **Authorized official:** JULIA E SAMS (CONTRACT COORDINATOR)
- **Authorized official phone:** (918) 494-8634

## Contact information

- **Practice address:** 2950 S ELM PL, SUITE 340, BROKEN ARROW, OK 74012-7877
- **Practice address phone:** (918) 451-0944
- **Practice address fax:** (918) 455-8598
- **Mailing address:** 2950 S ELM PL, SUITE 340, BROKEN ARROW, OK 74012-7877
- **Mailing address phone:** (918) 451-0944
- **Mailing address fax:** (918) 455-8598

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4676 | OK | Yes |

## Other

- **Enumeration date:** 03/18/2010
- **Last updated:** 03/18/2010