Organization
DENTAL DEPOT OF 145TH & N. PENN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN ALLEN ASHMORE DDS (OWNER / PRESIDENT)
(405) 748-3123
Entity
Organization
Contact information
Practice address
14440 N PENN AVE, OKLAHOMA CITY, OK 73134-6003
(405) 748-3123
(405) 748-3124
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 748-3123
(405) 748-3124
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3723
OK
Other
Enumeration date
03/14/2013
Last updated
06/25/2021
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