Organization
OKLAHOMA AESTHETIC RECONSTRUCTIVE SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY DILL (OFFICE ADMINISTRATOR)
(405) 735-9700
Entity
Organization
Contact information
Practice address
13820 WIRELESS WAY, OKLAHOMA CITY, OK 73134-2501
(405) 246-0391
(405) 246-0392
Mailing address
2708 W COUNTRY CLUB DR, OKLAHOMA CITY, OK 73116-4219
(405) 246-0391
(405) 246-0392
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
09/15/2021
Last updated
10/29/2021
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