Organization
OK SPECIALTY DENTAL SERVICES, PLLC
Active
Parent organization
OK SPECIALTY DENTAL SERVICES, PLLC
Other names
Yukon Kids Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
OK SPECIALTY DENTAL SERVICES, PLLC
Authorized official
CHARLOTTE DASCH (DIREC OF CRED AND PROV REL)
(504) 638-0303
Entity
Organization
Contact information
Practice address
1600 GARTH BROOKS BLVD, YUKON, OK 73099-6469
(405) 578-5234
Mailing address
1610 54TH AVE N STE 205, NASHVILLE, TN 37209-1442
(615) 678-0759
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
11/19/2024
Last updated
11/19/2024
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