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Organization
OKLAHOMA PERIODONTICS
Active
Organization
OKLAHOMA PERIODONTICS
Active
Other names
Eastern Oklahoma Periodotnics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BERNARD WYNN IV D.D.S. M.S. (PRESIDENT)
(918) 492-0737
Entity
Organization
Contact information
Practice address
6565 S YALE AVE, 1008, TULSA, OK 74136-8327
(918) 492-0737
(918) 492-9439
Mailing address
6565 S YALE AVE, 1008, TULSA, OK 74136-8327
(918) 492-0737
(918) 492-9439
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5447
OK
Other
Enumeration date
02/26/2009
Last updated
02/26/2009
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