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Organization

SDPMWC, PLLC

Active
Other names
Pediatric Dentistry of Oklahoma
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE YATES (CFO)
(918) 998-0996
Entity
Organization

Contact information

Practice address
1900 S AIR DEPOT BLVD STE 1B, MIDWEST CITY, OK 73110-5522
(405) 733-3553
(405) 733-5002
Mailing address
400 RIVERWALK TER STE 250, JENKS, OK 74037-5619
(918) 998-0996
(918) 310-1056

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
06/30/2021
Last updated
08/17/2022
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