Organization
CHILDREN'S DENTAL CLINIC OF OKLAHOMA CITY AT PORTLAND PLAZA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TRUDY WILLIAMS (DIRECTOR, LICENSING & CREDENTIALING)
(615) 750-0342
Entity
Organization
Contact information
Practice address
3637 NW 39TH ST, OKLAHOMA CITY, OK 73112-6309
(405) 942-7755
Mailing address
201 W 8TH ST, SUITE 810, PUEBLO, CO 81003-3038
(719) 562-4447
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/04/2006
Last updated
05/17/2010
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