Organization
OKLAHOMA PERIODONTICS
Active
Other names
Eastern Oklahoma Periodotnics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM BERNARD WYNN IV D.D.S. M.S. (PRESIDENT)
(918) 492-0737
Entity
Organization
Contact information
Practice address
6565 S YALE AVE, 1008, TULSA, OK 74136-8327
(918) 492-0737
(918) 492-9439
Mailing address
6565 S YALE AVE, 1008, TULSA, OK 74136-8327
(918) 492-0737
(918) 492-9439
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
5447
OK
Other
Enumeration date
02/26/2009
Last updated
02/26/2009
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