Organization
TOMMY L. MAYHUE D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TOMMY LEO MAYHUE D.D.S. (DENTIST / OWNER)
(405) 485-2020
Entity
Organization
Contact information
Practice address
1119 N COUNCIL AVE, BLANCHARD, OK 73010-8037
(405) 485-2020
Mailing address
PO BOX 575, BLANCHARD, OK 73010-0575
(405) 485-2020
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4419
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952454894
TYPE 1 NPI
OK
Enumeration date
05/09/2008
Last updated
05/09/2008
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