Organization
LEE A. ELIOT, DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY M WENTE (OFFICE ADMINISTRATOR)
(405) 340-5110
Entity
Organization
Contact information
Practice address
924 ROBTRICE CT, EDMOND, OK 73034-5714
(405) 340-5110
(405) 340-5162
Mailing address
924 ROBTRICE CT, EDMOND, OK 73034-5714
(405) 340-5110
(405) 340-5162
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4357
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104886282
TYPE 1 NPI NUMBER
OK
01
—
445562523001
BLUE CROSS PROVIDER
OK
Enumeration date
11/06/2006
Last updated
06/27/2008
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