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3645 N Council Rd Bethany OK 73008-3507 | |
| (405) 789-7893 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3645 N Council Rd, Bethany, Oklahoma |
| Authorized Official Name and Position | Cassandra Teutsch (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175408972 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3645 N Council Rd Bethany OK 73008-3507 Ph: (405) 789-7893 | 3645 N Council Rd Bethany OK 73008-3507 Ph: (405) 789-7893 |
| NPI Number | 1316485477 |
|---|---|
| Provider Enumeration Date | 02/08/2017 |
| Last Update Date | 02/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316485477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
Olson Dental Group, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6801 Nw 39th Expy, Suite A, Bethany, OK 73008 Phone: 405-787-1946 | |