Organization
TEJ D. LAD DDS INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEJ DATTATRAYA LAD DDS (DOCTOR)
(918) 369-6118
Entity
Organization
Contact information
Practice address
725 W MAIN ST, JENKS, OK 74037-3518
(918) 369-6118
(918) 369-6121
Mailing address
725 W MAIN ST, JENKS, OK 74037-3518
(918) 369-6118
(918) 369-6121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5667
OK
332BC3200X
Customized Equipment (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200095240A
—
OK
Enumeration date
01/11/2007
Last updated
10/21/2019
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