Organization
PHILLIP J ELASSAL DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP JAMES ELASSAL DDS (DENTIST)
(405) 682-0609
Entity
Organization
Contact information
Practice address
1601 SW 89TH STREET #G500, OKLAHOMA CITY, OK 73159
(405) 682-0609
(405) 682-2921
Mailing address
PO BOX 890910, OKLAHOMA CITY, OK 73189
(405) 682-0609
(405) 682-2921
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/18/2019
Last updated
12/18/2019
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