Organization
DIAMOND DENTAL, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LIGHTFOOT (AUTHORIZED REPRESENTATIVE)
(214) 702-0708
Entity
Organization
Contact information
Practice address
1991 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-6225
(405) 737-6622
Mailing address
15660 DALLAS PKWY STE 925, DALLAS, TX 75248-3323
(214) 702-0729
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
03/01/2019
Last updated
05/08/2023
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