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1518452952
NICOMA PARK DENTAL PLLC
OKLAHOMA CITY, OK
NPI
1518452952
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Entity Type
Organization
Authorized Contact
JASON WALLACE
Owner
405-413-7466
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2018-06-27
Last Update Date
2018-06-27
Business Address
NICOMA PARK DENTAL PLLC
10420 NE 23RD ST
OKLAHOMA CITY, OK 73141-5216
Phone number: 405-603-8520
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Mailing Address
NICOMA PARK DENTAL PLLC
3801 N BRYAN AVE
BETHANY, OK 73008-3001
Phone number: 405-413-7466
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