| Bartlesville Oral Surgery, Pllc | |
|
215 Se Howard Ave Bartlesville OK 74006 | |
| (918) 333-9155 | |
| (918) 333-9142 |
| Full Name | Bartlesville Oral Surgery, Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 215 Se Howard Ave, Bartlesville, Oklahoma |
| Authorized Official Name and Position | Michael Derrick Moody (OWNER) |
| Authorized Official Contact | 9183339155 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bartlesville Oral Surgery, Pllc 215 Se Howard Ave Bartlesville OK 74006 Ph: (918) 333-9155 | Bartlesville Oral Surgery, Pllc 215 Se Howard Ave Bartlesville OK 74006 Ph: (918) 333-9155 |
| NPI Number | 1568191096 |
|---|---|
| Provider Enumeration Date | 06/09/2022 |
| Last Update Date | 06/09/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568191096 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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