Organization
PROGRESSIVE DENTAL CARE OF TULSA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA LIGHTFOOT (AUTHORIZED REPRESENTATIVE)
(214) 702-0708
Entity
Organization
Contact information
Practice address
7614 E 91ST ST STE 120, TULSA, OK 74133-6047
(918) 477-7774
Mailing address
PO BOX 410168, KANSAS CITY, MO 64141-0168
(214) 702-0729
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/24/2019
Last updated
03/28/2023
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