Individual
MR. ERIC WAYNE WYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5196 S YALE AVENUE, TULSA, OK 74135
(918) 664-1888
(918) 664-0937
Mailing address
PO BOX 3040, BROKEN ARROW, OK 74013
(918) 664-1888
(918) 664-9037
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5301
OK
Other
Enumeration date
08/19/2006
Last updated
07/08/2007
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