Organization
IMMEDIATE SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PERRY BROOKS DDS (OWNER)
(405) 691-0155
Entity
Organization
Contact information
Practice address
11317 S WESTERN AVE STE 100B, OKLAHOMA CITY, OK 73170-5848
(405) 691-0155
(405) 369-7330
Mailing address
11317 S WESTERN AVE STE 100B, OKLAHOMA CITY, OK 73170-5848
(405) 691-0155
(405) 369-7330
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114918844
INDIVIDUAL NPI
—
Enumeration date
04/15/2022
Last updated
04/15/2022
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