Organization
NORMAN SURGICAL ARTS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MERLIN EDMUND BRALY DDS (PHYSICIAN)
(405) 364-6777
Entity
Organization
Contact information
Practice address
640 24TH AVE SW, NORMAN, OK 73069-3913
(405) 364-6777
(405) 364-6789
Mailing address
PO BOX 269029, OKLAHOMA CITY, OK 73126-9029
(405) 848-7974
(405) 848-0033
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3765 AND 5216
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200088680A
—
OK
Enumeration date
09/20/2006
Last updated
02/22/2012
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