Organization
DENTAL DEPOT ORTHODONTICS DEL CITY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLON ZISSA (DIRECTOR OF PROVIDER RELATIONS)
(405) 945-8941
Entity
Organization
Contact information
Practice address
5004 SE 29TH ST STE B, DEL CITY, OK 73115-4710
(405) 900-8939
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 900-8939
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/06/2023
Last updated
09/06/2023
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