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Organization

DR. THOMASON M MCCONNELL DDS

Active
Other names
Family Dentistry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. THOMASON MICHAEL MCCONNELL D.D.S. (DENTIST)
(918) 458-9100
Entity
Organization

Contact information

Practice address
1200 W 4TH ST STE A, TAHLEQUAH, OK 74464-5013
(918) 458-9100
(918) 458-9200
Mailing address
1200 W 4TH ST STE A, TAHLEQUAH, OK 74464-5013
(918) 458-9100
(918) 458-9200

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5267
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
214781
TRIGON
VA
01
814714
UNITED CONCORDIA
Enumeration date
02/01/2007
Last updated
08/22/2020
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