# TULSA DENTAL IMPLANT CENTER

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

## Provider details

- **NPI number:** 1326273996
- **Authorized official:** DR. JORGE JUDY MADAMBA DDS (DENTIST)
- **Authorized official phone:** (918) 627-3900

## Contact information

- **Practice address:** 5151 E 51ST ST, SUITE 102, TULSA, OK 74135-7457
- **Practice address phone:** (918) 627-3900
- **Practice address fax:** (918) 627-7077
- **Mailing address:** 5151 E 51ST ST STE 102, TULSA, OK 74135-7450
- **Mailing address phone:** (918) 627-3900
- **Mailing address fax:** (918) 627-7077

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | 3173 | OK | Yes |

## Other

- **Enumeration date:** 05/26/2009
- **Last updated:** 05/26/2009