Organization
PREMIERE DENTISTRY OF TAHLEQUAH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT STEPHEN JONES DDS (DENTIST)
(918) 456-2555
Entity
Organization
Contact information
Practice address
1205 E ROSS BYPASS, TAHLEQUAH, OK 74464
(918) 456-2555
(918) 456-2444
Mailing address
1205 E ROSS BYPASS, TAHLEQUAH, OK 74464
(918) 456-2555
(918) 456-2444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200021320
—
OK
Enumeration date
03/21/2006
Last updated
04/06/2010
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