# LARRY D. LANDER D.D.S.,M.S. INC

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

## Provider details

- **NPI number:** 1619291762
- **Authorized official:** JULIA E SAMS (CONTRACT COORDINATOR)
- **Authorized official phone:** (918) 494-8634

## Contact information

- **Practice address:** 6132 E 61ST ST, TULSA, OK 74136-2117
- **Practice address phone:** (918) 494-8634
- **Practice address fax:** (918) 494-8636
- **Mailing address:** 6132 E 61ST ST, TULSA, OK 74136-2117
- **Mailing address phone:** (918) 494-8634
- **Mailing address fax:** (918) 494-8636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 3818 | OK | Yes |

## Other

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