# DENTAL DEPOT OF I-44 & HARVARD, PLLC

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

## Provider details

- **NPI number:** 1548779135
- **Authorized official:** GLENN ALLAN ASHMORE DDS (PRESIDENT / OWNER)
- **Authorized official phone:** (918) 742-2123

## Contact information

- **Practice address:** 4770 S. HARVARD AVE., TULSA, OK 74135-3024
- **Practice address phone:** (918) 742-2123
- **Practice address fax:** (918) 742-2124
- **Mailing address:** 2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
- **Mailing address phone:** (918) 742-2123
- **Mailing address fax:** (918) 742-2124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3723 | OK | Yes |

## Other

- **Enumeration date:** 09/26/2017
- **Last updated:** 07/21/2022