Individual
SANDRA MARIA PEROZO VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9607 E 95TH CT S, TULSA, OK 74133-5839
(918) 288-0818
Mailing address
6689 E 129TH ST S, BIXBY, OK 74008-2503
(832) 991-2555
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
088
OK
Other
Enumeration date
06/14/2023
Last updated
06/14/2023
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