Organization
FORD DENTAL LAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VICTOR LEON STOLBACH (PARTNER)
(405) 887-0502
Entity
Organization
Contact information
Practice address
2828 NW 57TH ST, 307, OKLAHOMA CITY, OK 73112-6814
(405) 887-0502
Mailing address
2828 NW 57TH ST STE 307, OKLAHOMA CITY, OK 73112
(405) 795-3169
Taxonomy
Speciality
Code
Description
License number
State
292200000X
Dental Laboratory
Primary
DL65
OK
Other
Enumeration date
02/03/2017
Last updated
02/03/2017
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