# JOHNSON AND SOUTHARD ENDODONTICS

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

## Provider details

- **NPI number:** 1649416876
- **Authorized official:** DR. LAURIE LYNN SOUTHARD DDS (PRESIDENT/ENDODONTIST)
- **Authorized official phone:** (918) 493-3880

## Contact information

- **Practice address:** 5010 E 68TH ST, SUITE 104, TULSA, OK 74136-3323
- **Practice address phone:** (918) 493-3880
- **Practice address fax:** (918) 492-8564
- **Mailing address:** 5010 E 68TH ST, SUITE 104, TULSA, OK 74136-3323
- **Mailing address phone:** (918) 493-3880
- **Mailing address fax:** (918) 492-8564

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 5119 | OK | Yes |

## Other

- **Enumeration date:** 12/17/2008
- **Last updated:** 12/17/2008