Individual
DR. PHILLIP ALAN TYNDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
415 E HARTFORD AVE, PONCA CITY, OK 74601-1512
(580) 762-7857
(580) 762-2788
Mailing address
415 E HARTFORD AVE, PONCA CITY, OK 74601-1512
(580) 762-7857
(580) 762-2788
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5342
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100126460A
—
OK
Enumeration date
09/30/2005
Last updated
04/24/2008
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