Organization
DENTAL DEPOT OF TULSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN ALLEN ASHMORE DDS (PRESIDENT)
(405) 832-1123
Entity
Organization
Contact information
Practice address
2145 S SHERIDAN RD, TULSA, OK 74129-1001
(405) 832-1123
(405) 601-5453
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 832-1123
(405) 601-5453
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3723
OK
Other
Enumeration date
12/15/2010
Last updated
06/25/2021
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