Organization
BRENT T. AMAYA D.D.S. P.L.L.C.
Active
Other names
Diamond Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT THOMAS AMAYA D.D.S. (DENTIST)
(405) 737-6622
Entity
Organization
Contact information
Practice address
1991 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-6225
(405) 737-6622
(405) 733-2250
Mailing address
1991 S DOUGLAS BLVD, MIDWEST CITY, OK 73130-6225
(405) 737-6622
(405) 733-2250
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6273
OK
Other
Enumeration date
11/27/2012
Last updated
01/30/2014
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