Organization
OLIVE DENTAL OKC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON MICHAEL ONLEY DDS (MANAGER)
(405) 612-8577
Entity
Organization
Contact information
Practice address
5500 NW EXPRESSWAY STE B, WARR ACRES, OK 73132-5218
(405) 470-2200
(405) 470-2392
Mailing address
5500 NW EXPRESSWAY STE B, WARR ACRES, OK 73132-5218
(405) 470-2200
(405) 470-2392
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891286092
—
OK
Enumeration date
12/18/2019
Last updated
12/18/2019
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