Individual
DR. THOMASON MICHAEL MCCONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1200 W 4TH ST, SUITE A, TAHLEQUAH, OK 74464-5013
(918) 458-9100
(918) 458-9200
Mailing address
1200 W 4TH ST, SUITE A, TAHLEQUAH, OK 74464-5013
(918) 458-9100
(918) 458-9200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5267
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
214781
BC/BS OF VIRGINIA
VA
01
—
814714
UNITED CONCORDIA
PA
Enumeration date
07/22/2006
Last updated
07/09/2007
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