Organization
DEREK R MASK DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEMETRA PRATER (OFFICE MANAGER)
(405) 321-5143
Entity
Organization
Contact information
Practice address
2500 MCGEE DR STE 131, NORMAN, OK 73072-6796
(405) 321-5143
(405) 321-5350
Mailing address
2500 MCGEE DR STE 131, NORMAN, OK 73072-6796
(405) 321-5143
(405) 321-5350
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5489
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OK02809501
BLUE CROSS BLUE SHIELD
OK
Enumeration date
05/01/2008
Last updated
05/01/2008
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