| Dental Depot Orthodontics Broken Arrow, Pllc | |
|
1950 W Kenosha St Ste B Broken Arrow OK 74012-8944 | |
| (539) 476-9588 | |
| Not Available |
| Full Name | Dental Depot Orthodontics Broken Arrow, Pllc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1950 W Kenosha St Ste B, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Gaylon Zissa (DIRECTOR OF PROVIDER RELATIONS) |
| Authorized Official Contact | 4059458941 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Depot Orthodontics Broken Arrow, Pllc 2828 Nw 30th St Oklahoma City OK 73112-7404 Ph: (405) 945-8941 | Dental Depot Orthodontics Broken Arrow, Pllc 1950 W Kenosha St Ste B Broken Arrow OK 74012-8944 Ph: (539) 476-9588 |
| NPI Number | 1508679598 |
|---|---|
| Provider Enumeration Date | 01/31/2025 |
| Last Update Date | 01/31/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508679598 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
Medical Consultant Services Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3309 W Princeton St, Broken Arrow, OK 74012 Phone: 419-819-9498 | |
Randy Fagan Dds, Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2221 W Washington St, Broken Arrow, OK 74012 Phone: 918-455-6406 Fax: 918-455-1856 | |
Family Dentistry Of Broken Arrow Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 S Elm Pl, Suite E, Broken Arrow, OK 74012 Phone: 918-455-3777 Fax: 918-451-6316 | |
Spring Dental-broken Arrow Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6416 S Elm Pl, Broken Arrow, OK 74011 Phone: 918-895-6568 |