# FOOTHILLS ORAL & MAXILLOFACIAL SURGERY

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

## Provider details

- **NPI number:** 1942521687
- **Authorized official:** DR. MICHAEL PAUL WINKLER DDS, MS (CEO)
- **Authorized official phone:** (918) 457-9779

## Contact information

- **Practice address:** 1500 E DOWNING ST, TAHLEQUAH, OK 74464-3234
- **Practice address phone:** (918) 456-0671
- **Practice address fax:** (918) 457-5761
- **Mailing address:** 29062 S 558 RD, PARK HILL, OK 74451-2876
- **Mailing address phone:** (918) 457-9779
- **Mailing address fax:** (918) 457-5761

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 147 | OK | Yes |

## Other

- **Enumeration date:** 06/17/2010
- **Last updated:** 06/17/2010