Organization
PREMIERE DENTISTRY OF TAHLEQUAH, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT S JONES DDS (DENTIST OWNER)
(918) 456-2555
Entity
Organization
Contact information
Practice address
1205 E ROSS BYP, TAHLEQUAH, OK 74464-4188
(918) 456-2555
(918) 456-2444
Mailing address
1205 E ROSS BYP, TAHLEQUAH, OK 74464-4188
(918) 456-2555
(918) 456-2444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200021320A
—
OK
Enumeration date
04/30/2008
Last updated
05/13/2008
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