Organization
OWASSO ORTHODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMI WILLIAMSON (OFFICE MANAGER)
(918) 272-4242
Entity
Organization
Contact information
Practice address
12813 E 101ST PL N, OWASSO, OK 74055-4662
(918) 272-4242
(918) 272-5753
Mailing address
12813 E 101ST PL N, OWASSO, OK 74055-4662
(918) 272-4242
(918) 272-5753
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200048910A
—
OK
Enumeration date
03/01/2011
Last updated
03/01/2011
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