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Organization

TRI CITY ORAL SURGERY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAYNE JENSEN DMD (DENTIST)
(405) 474-6362
Entity
Organization

Contact information

Practice address
2822 NW 32ND ST, NEWCASTLE, OK 73065-6576
(405) 474-6362
(405) 513-6542
Mailing address
2822 NW 32ND ST, NEWCASTLE, OK 73065-6576
(405) 474-6362
(405) 513-6542

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary

Other

Enumeration date
05/18/2016
Last updated
05/18/2016
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