Organization
PARKS FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARA PARKS (OFFICE MANAGER)
(580) 371-3900
Entity
Organization
Contact information
Practice address
1520 E. MAIN STREET, TISHOMINGO, OK 73460
(580) 371-3900
(580) 371-3903
Mailing address
1520 E. MAIN STREET, TISHOMINGO, OK 73460
(580) 371-3900
(580) 371-3903
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
1124
OK
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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