Organization
PHILLIP A. TYNDALL, DDS,PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY TYNDALL RDH (RDH/OFFICE MANAGER)
(580) 762-7857
Entity
Organization
Contact information
Practice address
415 E HARTFORD AVE, PONCA CITY, OK 74601-1512
(580) 762-7857
Mailing address
415 E HARTFORD AVE, PONCA CITY, OK 74601-1512
(580) 762-7857
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5342
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100126460A
—
OK
Enumeration date
05/05/2008
Last updated
05/05/2008
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