# TOMMY L. MAYHUE D.D.S.

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

## Provider details

- **NPI number:** 1831366848
- **Authorized official:** DR. TOMMY LEO MAYHUE D.D.S. (DENTIST / OWNER)
- **Authorized official phone:** (405) 485-2020

## Contact information

- **Practice address:** 1119 N COUNCIL AVE, BLANCHARD, OK 73010-8037
- **Practice address phone:** (405) 485-2020
- **Mailing address:** PO BOX 575, BLANCHARD, OK 73010-0575
- **Mailing address phone:** (405) 485-2020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4419 | OK | Yes |

## Other

- **Enumeration date:** 05/09/2008
- **Last updated:** 05/09/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1952454894 | TYPE 1 NPI | OK |