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Organization
PREMIERE FAMILY DENTISTRY OF TAHLEQUAH, PLLC
Active
Organization
PREMIERE FAMILY DENTISTRY OF TAHLEQUAH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK SMITH DDS (SENIOR MANAGER)
(918) 456-2555
Entity
Organization
Contact information
Practice address
1205 E ROSS BYP, TAHLEQUAH, OK 74464-4188
(918) 456-2555
(918) 456-2444
Mailing address
1205 E ROSS BYP, TAHLEQUAH, OK 74464-4188
(918) 456-2555
(918) 456-2444
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/16/2021
Last updated
11/16/2021
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