Organization
DENTAL DEPOT ORTHODONTICS CENTRAL OKC PLLC
Active
Parent organization
GLENN A ASHMORE DDS INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GLENN A ASHMORE DDS INC
Authorized official
GAYLON ZISSA (DIRECTOR)
(405) 945-8941
Entity
Organization
Contact information
Practice address
4025 NW 63RD ST, OKLAHOMA CITY, OK 73116-1911
(405) 945-8940
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
6025
OK
Other
Enumeration date
01/23/2014
Last updated
01/11/2024
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