Organization
DENTAL DEPOT 91ST & INDIAN SCHOOL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN A ASHMORE (OWNER / CEO)
(405) 945-8941
Entity
Organization
Contact information
Practice address
4115 N. 91ST AVE., PHOENIX, AZ 85037
(623) 604-6723
(480) 741-8850
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 945-8941
(405) 945-8959
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/30/2025
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