Organization
OU CHILDRENS PHYSICIANS DENTAL SERVICE-OUCP DENTAL SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID ALAN CIESLA D.D.S., MS (PROGRAM DIRECTOR)
(405) 271-4750
Entity
Organization
Contact information
Practice address
1200 CHILDRENS AVE STE 8F, OKLAHOMA CITY, OK 73104-4637
(405) 271-4750
(405) 271-4055
Mailing address
1200 CHILDRENS AVE STE 8F, OKLAHOMA CITY, OK 73104-4637
(405) 271-4750
(405) 271-2922
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100749330A
—
OK
Enumeration date
07/22/2006
Last updated
05/16/2024
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