# ENDODONTIC SPECIALISTS OF NORTHEAST OK

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

## Provider details

- **NPI number:** 1790951614
- **Authorized official:** ARMELLA GLENN BS (OFFICE MANAGER)
- **Authorized official phone:** (918) 524-3366

## Contact information

- **Practice address:** 5555 E 71ST ST, STE 9210, TULSA, OK 74136-6542
- **Practice address phone:** (918) 524-3366
- **Practice address fax:** (918) 524-3399
- **Mailing address:** 5555 E 71ST ST, STE 9210, TULSA, OK 74136-6542
- **Mailing address phone:** (918) 524-3366
- **Mailing address fax:** (918) 524-3399

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | 5644 | OK | Yes |

## Other

- **Enumeration date:** 04/30/2008
- **Last updated:** 04/30/2008