Organization
DENTAL DEPOT ORTHODONTICS SW OKC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN ALLAN ASHMORE DDS (OWNER / PRESIDENT)
(405) 949-0123
Entity
Organization
Contact information
Practice address
6217 S WESTERN AVE STE A, OKLAHOMA CITY, OK 73139-1605
(405) 606-7123
(405) 606-7130
Mailing address
6217 S WESTERN AVE STE A, OKLAHOMA CITY, OK 73139-1605
(405) 606-7123
(405) 606-7130
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
07/07/2014
Last updated
07/07/2014
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