# DR. MICAH J. BEVINS D.D.S.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bevins Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962677344
- **Authorized official:** MICAH JON BEVINS D.D.S. (GENERAL DENTIST)
- **Authorized official phone:** (918) 252-4444

## Contact information

- **Practice address:** 6349 S MEMORIAL DR, SUITE B, TULSA, OK 74133-1928
- **Practice address phone:** (918) 252-4444
- **Practice address fax:** (918) 252-4333
- **Mailing address:** 6349 S MEMORIAL DR, SUITE B, TULSA, OK 74133-1928
- **Mailing address phone:** (918) 252-4444
- **Mailing address fax:** (918) 252-4333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0001X | Public Health Dentistry | — | NULL | Yes |
| 1223D0001X | Public Health Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2008
- **Last updated:** 04/25/2008