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Organization
HENYRETTA DENTAL CENTER 2, PLLC
Active
Organization
HENYRETTA DENTAL CENTER 2, PLLC
Active
Other names
Henryetta Dental Center, PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY SCOTT JOHNSON D.D.S. (DENTIST)
98186522555
Entity
Organization
Contact information
Practice address
121 S 6TH ST, HENRYETTA, OK 74437-5009
(918) 652-2555
(918) 652-2556
Mailing address
121 S 6TH ST, HENRYETTA, OK 74437-5009
(918) 652-2555
(918) 652-2556
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
5868
OK
Other
Enumeration date
08/09/2011
Last updated
08/09/2011
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