Organization
TULSA DENTAL IMPLANT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE JUDY MADAMBA DDS (DENTIST)
(918) 627-3900
Entity
Organization
Contact information
Practice address
5151 E 51ST ST, SUITE 102, TULSA, OK 74135-7457
(918) 627-3900
(918) 627-7077
Mailing address
5151 E 51ST ST STE 102, TULSA, OK 74135-7450
(918) 627-3900
(918) 627-7077
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
3173
OK
Other
Enumeration date
05/26/2009
Last updated
05/26/2009
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