Organization
MARK W MERIDETH DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK WADE MERIDETH DDS (PRESIDENT)
(405) 640-4435
Entity
Organization
Contact information
Practice address
1641 S DELAWARE AVE, TULSA, OK 74104-5909
(405) 640-4435
Mailing address
1641 S DELAWARE AVE, TULSA, OK 74104-5909
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5807
OK
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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