Organization
PEDIATRIC DENTISTRY OF OKLAHOMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN S MURPHY (OFFICE MANAGER)
(405) 946-2455
Entity
Organization
Contact information
Practice address
3613 NW 56TH ST STE 105, OKLAHOMA CITY, OK 73112-4520
(405) 946-2455
(405) 946-3445
Mailing address
3613 NW 56TH ST STE 105, OKLAHOMA CITY, OK 73112-4520
(405) 946-2455
(405) 946-3445
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100122730A
—
OK
01
—
1184868960
NPI
—
01
—
1720063225
NPI
—
Enumeration date
05/20/2021
Last updated
05/20/2021
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