Organization
ORTHODONTICS EXCLUSIVELY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY MICHAEL SHANNON DDS, MS, PC (OWNER/ORTHODONTIST)
(405) 321-2735
Entity
Organization
Contact information
Practice address
2214 W BOYD ST, NORMAN, OK 73069-4836
(405) 321-2735
(405) 321-7877
Mailing address
2214 W BOYD ST, NORMAN, OK 73069-4836
(405) 321-2735
(405) 321-7877
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
136
OK
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
166
OK
Other
Enumeration date
03/17/2008
Last updated
03/17/2008
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