Individual
DR. ARTHUR LEE HOLLEMAN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
550 S PEORIA AVE, TULSA, OK 74120-3820
(918) 588-1900
(918) 582-6405
Mailing address
550 S PEORIA AVE, TULSA, OK 74120-3820
(918) 588-1900
(918) 582-6405
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5787
OK
1223G0001X
General Practice Dentistry
Primary
5787
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100732910-A
GROUP MEDICAID/SOONERCARE
OK
01
—
100732910-G
GROUP MEDICAID/SOONERCARE
OK
05
—
200108180 A
—
OK
01
—
73-1042545
GROUP MEDICARE
OK
01
—
731042545001
GROUP TRICARE
OK
Enumeration date
10/11/2006
Last updated
04/22/2020
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