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Organization

WESLEY NEILL BLACK DDS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. WESLEY NEILL BLACK DDS (OWNER/DENTIST)
(918) 745-0500
Entity
Organization

Contact information

Practice address
6112E 61ST STREET, TULSA, OK 74136
(918) 745-0500
(918) 712-9913
Mailing address
6112 E 61ST STREET, TULSA, OK 74136
(918) 745-0500
(918) 712-9913

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5573
OK

Other

Enumeration date
05/30/2008
Last updated
05/10/2018
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