Organization
DENTAL DEPOT ORTHODONTICS NORTH OKC PLLC
Active
Parent organization
DENTAL DEPOT OF 145TH AND PENN PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
DENTAL DEPOT OF 145TH AND PENN PLLC
Authorized official
GAYLON ZISSA (DIRECTOR)
(405) 945-8941
Entity
Organization
Contact information
Practice address
14440 N PENN AVE, OKLAHOMA CITY, OK 73134-6003
(405) 748-3123
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 945-8941
(405) 945-8959
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
196
OK
Other
Enumeration date
01/29/2014
Last updated
01/11/2024
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