Organization
PKL ORTHODONTICS, PC
Active
Other names
Sky Ortho
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRISCILLA PICKENS-LARSON DMD (OWNER/ ORTHODONTIST)
(405) 378-4774
Entity
Organization
Contact information
Practice address
717 S I 35 SERVICE RD STE C, MOORE, OK 73160-3190
(405) 378-4774
Mailing address
717 S I 35 SERVICE RD STE C, MOORE, OK 73160-3190
(405) 378-4774
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
189
OK
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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