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Organization
OK OMS SPECIALTY DENTAL SERVICES
Active
Organization
OK OMS SPECIALTY DENTAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE DASCH (DIRECTOR OF CREDENTIALING & PR)
(504) 638-0303
Entity
Organization
Contact information
Practice address
5940 NW EXPRESSWAY, STE 150, OKLAHOMA CITY, OK 73132
(405) 495-5600
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/12/2024
Last updated
04/12/2024
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