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Individual

ALISA BURROSS RATZLAFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
13901 PARKWAY COMMONS DR STE D, OKLAHOMA CITY, OK 73134-6225
(940) 613-6940
Mailing address
11225 BLUE SAGE RD, OKLAHOMA CITY, OK 73120-5348
(940) 613-6940

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
222758
TX
1223G0001X
General Practice Dentistry
Primary
7273
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1558424788
DENTIST
OK
01
1558424788
DENTIST
TX
Enumeration date
12/19/2006
Last updated
05/18/2023
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