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811 S.w. 19th St. Suite A Moore OK 73160-2802 | |
| (405) 703-5161 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 811 S.w. 19th St., Moore, Oklahoma |
| Authorized Official Name and Position | Yong Hong (MEMBER) |
| Authorized Official Contact | 4057035161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
811 S.w. 19th St. Suite A Moore OK 73160-2802 Ph: (405) 703-5161 | 811 S.w. 19th St. Suite A Moore OK 73160-2802 Ph: (405) 703-5161 |
| NPI Number | 1386901403 |
|---|---|
| Provider Enumeration Date | 04/13/2012 |
| Last Update Date | 04/13/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386901403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 6104 (Oklahoma) | Primary |
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