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Organization
DENTAL DEPOT OF BROKEN ARROW, PLLC
Active
Organization
DENTAL DEPOT OF BROKEN ARROW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN ALLAN ASHMORE DDS (OWNER / PRESIDENT)
(405) 949-0123
Entity
Organization
Contact information
Practice address
1950 W KENOSHA ST, BROKEN ARROW, OK 74012-8944
(405) 945-8941
(405) 945-8959
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 945-8941
(405) 945-8959
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3723
OK
Other
Enumeration date
03/27/2014
Last updated
06/22/2021
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