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Organization

DENTAL DEPOT OF PIEDMONT, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GAYLON ZISSA (DIRECTOR OF PROVIDER RELATIONS)
(405) 945-8941
Entity
Organization

Contact information

Practice address
11401 NW EXPRESSWAY, YUKON, OK 73099-8721
(405) 754-1906
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 945-8941
(405) 945-8959

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
01/31/2025
Last updated
01/31/2025
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