Organization
JONAH R B VANDIVER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONAH VANDIVER DDS (PRESIDENT)
(918) 492-1917
Entity
Organization
Contact information
Practice address
7104 S SHERIDAN RD, SUITE 8, TULSA, OK 74133-2770
(918) 492-1917
(918) 492-4538
Mailing address
7104 S SHERIDAN RD, SUITE 8, TULSA, OK 74133-2770
(918) 492-1917
(918) 492-4538
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5392
OK
Other
Enumeration date
11/02/2007
Last updated
11/02/2007
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