Organization
EAST 111 FAMILY DENTISTRY PLLC
Active
Other names
Tej Lad DDS
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
8194 E 111TH ST S, BIXBY, OK 74008-2421
(918) 369-6118
Mailing address
8194 E 111TH ST S, BIXBY, OK 74008-2421
(918) 369-6118
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/13/2020
Last updated
08/13/2020
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