Organization
PEDIATRIC DENTISTRY OF TULSA P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD LYNN WINDER D.D.S. (PRESIDENT)
(918) 664-9797
Entity
Organization
Contact information
Practice address
5602 S MEMORIAL DR, TULSA, OK 74145-9016
(918) 664-9797
(918) 664-1666
Mailing address
5602 S MEMORIAL DR, TULSA, OK 74145-9016
(918) 664-9797
(918) 664-1666
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
3620
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013754
UNITED CONCORDIA
OK
05
—
100191810A
—
OK
Enumeration date
05/21/2008
Last updated
05/21/2008
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