Organization
DENTRUST OKLAHOMA, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA CLARK (CREDENTIALING)
(813) 451-4503
Entity
Organization
Contact information
Practice address
BLDG 1712, MACOMB RD, FT.STILL, OK 73503-4533
(267) 927-5000
(267) 927-5000
Mailing address
6097 EASTON RD, PIPERSVILLE, PA 18947-1810
(267) 927-5000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/31/2020
Last updated
01/31/2020
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