Organization
DERMATOLOGY AND COSMETIC CENTER OF OKLAHOMA, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA NICOLE DOTY MD (PRESIDENT)
(405) 701-9073
Entity
Organization
Contact information
Practice address
3580 RC LUTTRELL DR STE 102, NORMAN, OK 73072-9702
(405) 701-9073
(405) 310-8708
Mailing address
5355 RETREAT CIR, LONGMONT, CO 80503-7627
(405) 701-9073
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
12/16/2018
Last updated
02/20/2019
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