Organization
LAKECREST DENTAL-OWASSO 96TH
Active
Other names
Lakecrest Owasso
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE MAYRE MOSS (OFFICE MANAGER)
(918) 376-6165
Entity
Organization
Contact information
Practice address
9551 N. OWASSO EXPRESSWAY, SUITE #100, OWASSO, OK 74055
(918) 376-6165
(918) 376-6160
Mailing address
9551 N. OWASSO EXPY SUITE 100, OWASSO, OK 74055
(918) 376-6165
(918) 376-6160
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
10/29/2019
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