Individual
AMY SUSAN JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5510 E 41ST ST STE C, TULSA, OK 74135-6037
(918) 641-4635
Mailing address
11421 S JAMES AVE, JENKS, OK 74037-1715
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7921
OK
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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