Organization
DENTAL DEPOT ORTHODONTICS TECUMSEH, PLLC
Active
Organization
DENTAL DEPOT ORTHODONTICS TECUMSEH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAYLON ZISSA (DIRECTOR OF PROVIDER RELATIONS)
(405) 945-8941
Entity
Organization
Contact information
Practice address
3401 W TECUMSEH RD STE B, NORMAN, OK 73072-1809
(405) 402-4554
(405) 292-4180
Mailing address
2828 NW 30TH ST, OKLAHOMA CITY, OK 73112-7404
(405) 402-4554
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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