Organization
EAST NORMAN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY LAVELETT D.D.S. (DENTIST)
(405) 360-0018
Entity
Organization
Contact information
Practice address
443 12TH AVE NE, NORMAN, OK 73071-5241
(405) 360-0018
(405) 360-1178
Mailing address
443 12TH AVE NE, NORMAN, OK 73071-5241
(405) 360-0018
(405) 360-1178
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4835
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4835
APWU
—
Enumeration date
05/20/2008
Last updated
05/20/2008
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