# DENTAL DEPOT OF 145TH & N. PENN

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

## Provider details

- **NPI number:** 1922349026
- **Authorized official:** DR. GLENN ALLEN ASHMORE DDS (OWNER / PRESIDENT)
- **Authorized official phone:** (405) 748-3123

## Contact information

- **Practice address:** 14440 N PENN AVE, OKLAHOMA CITY, OK 73134-6003
- **Practice address phone:** (405) 748-3123
- **Practice address fax:** (405) 748-3124
- **Mailing address:** 2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
- **Mailing address phone:** (405) 748-3123
- **Mailing address fax:** (405) 748-3124

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 3723 | OK | Yes |

## Other

- **Enumeration date:** 03/14/2013
- **Last updated:** 06/25/2021