Organization
DENTAL DEPOT HEFNER STATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIENNE HOLDSCLEW (OFFICE MANAGER)
(405) 722-0123
Entity
Organization
Contact information
Practice address
7130 WEST HEFNER ROAD, OKLAHOMA CITY, OK 73162
(405) 722-0123
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 722-0123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3723
OK
Other
Enumeration date
06/13/2007
Last updated
06/25/2021
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