Organization
SPRING DENTAL-PEORIA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEE MCBAY (CREDENTIALING SPECIALIST)
(918) 998-0996
Entity
Organization
Contact information
Practice address
4955 S. PEORIA AVE, TULSA, OK 74105
(918) 872-7140
Mailing address
400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
(918) 998-0996
(918) 235-9079
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6435
OK
Other
Enumeration date
05/29/2013
Last updated
06/14/2018
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