Organization
PDAA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BRIAN MOLLOY (OWNER/PRESIDENT)
(405) 692-1222
Entity
Organization
Contact information
Practice address
9801 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-6925
(405) 692-1222
Mailing address
9801 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-6925
(405) 692-1222
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
04/26/2012
Last updated
04/26/2012
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