# TULSA COSMETIC DENTAL CENTER

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

## Provider details

- **NPI number:** 1821257890
- **Authorized official:** DR. JEROME Y CHA (PRESIDENT)
- **Authorized official phone:** (918) 496-1919

## Contact information

- **Practice address:** 9445 S MINGO RD, TULSA, OK 74133-5792
- **Practice address phone:** (918) 496-1919
- **Mailing address:** 9445 S MINGO RD, TULSA, OK 74133-5792
- **Mailing address phone:** (918) 496-1919

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 06/05/2008
- **Last updated:** 06/05/2008