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Organization
UNIVERSITY ORAL & MAXILLOFACIAL SURGEONS
Active
Organization
UNIVERSITY ORAL & MAXILLOFACIAL SURGEONS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA R NICHOLS (OFFICE MANAGER)
(405) 271-4441
Entity
Organization
Contact information
Practice address
1201 NORTH STONEWALL AVENUE, OKLAHOMA CITY, OK 73117
(405) 271-4441
(405) 271-1134
Mailing address
1201 N STONEWALL AVE, DCS206, OKLAHOMA CITY, OK 73117-1214
(405) 271-4441
(405) 271-1134
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
04/03/2007
Last updated
08/22/2020
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