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BOARD OF REGENTS OF OK - COL OF DENTISTRY GRAD PERODONTICS

Active
Other names
Col of Dentistry Grad
Organization subpart
No

Provider details

NPI number
Authorized official
LISA ASCH (ASSOCIATE DIRECTOR RESARCH ADMIN)
(405) 271-2090
Entity
Organization

Contact information

Practice address
1201 N STONEWALL AVE RM DCS253, OKLAHOMA CITY, OK 73117-1214
(405) 271-6531
(405) 271-2922
Mailing address
PO BOX 26901, OKLAHOMA CITY, OK 73126-0901
(405) 271-6531

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary

Other

Enumeration date
04/02/2012
Last updated
04/02/2012
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