Organization
FOOTHILLS ORAL & MAXILLOFACIAL SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PAUL WINKLER DDS, MS (CEO)
(918) 457-9779
Entity
Organization
Contact information
Practice address
1500 E DOWNING ST, TAHLEQUAH, OK 74464-3234
(918) 456-0671
(918) 457-5761
Mailing address
29062 S 558 RD, PARK HILL, OK 74451-2876
(918) 457-9779
(918) 457-5761
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
147
OK
Other
Enumeration date
06/17/2010
Last updated
06/17/2010
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