# SENIOR DENTAL CARE OF IL, LLC

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

## Provider details

- **NPI number:** 1689216897
- **Authorized official:** DR. DEREN FLESHER DDS (OWNER)
- **Authorized official phone:** (913) 594-3088

## Contact information

- **Practice address:** 7101 NW 150TH ST STE 100, OKLAHOMA CITY, OK 73142-9716
- **Practice address phone:** (913) 594-3088
- **Mailing address:** 8500 W 110TH ST STE 450, OVERLAND PARK, KS 66210-4029
- **Mailing address phone:** (913) 594-3088

## Taxonomy

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

## Other

- **Enumeration date:** 10/09/2019
- **Last updated:** 10/09/2019