Organization
DENTAL DEPOT OF MOORE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRYSON POGSON (DIR. OF BUSINESS DEVELOPMENT)
(405) 945-8941
Entity
Organization
Contact information
Practice address
2709 S. I-35 FRONTAGE RD, SUITE B, MOORE, OK 73160
(405) 799-9123
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 799-9123
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/09/2009
Last updated
06/25/2021
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