Organization
GREEN COUNTRY DENTAL ARTS OF CATOOSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SOREN CHASE MICHAELSEN D.D.S. (DENTIST)
(918) 266-6470
Entity
Organization
Contact information
Practice address
1755 N. HIGHWAY 66, SUITE C, CATOOSA, OK 74015
(918) 266-6470
(918) 266-6473
Mailing address
PO BOX 1980, CATOOSA, OK 74015-1980
(918) 266-6470
(918) 266-6473
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6403
OK
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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