Individual
MARK HARRISON HERDADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
19600 E ROSS ST, TAHLEQUAH, OK 74464-0545
(539) 234-1000
Mailing address
1515 E 21ST ST, TULSA, OK 74114-1339
(918) 313-3918
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
TBD
OK
Other
Enumeration date
04/08/2026
Last updated
05/13/2026
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