Organization
DENTAL ARTS OF LOCUST GROVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOREN MICHAELSEN DDS (OWNER)
(405) 593-9596
Entity
Organization
Contact information
Practice address
409 E MAIN ST, LOCUST GROVE, OK 74352-5116
(918) 888-5055
Mailing address
PO BOX 549, LOCUST GROVE, OK 74352-0549
(918) 888-5055
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2023
Last updated
08/28/2023
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