| Diamond Smiles Dental | |
|
1506 W Chickasaw Ave Sallisaw OK 74955-7200 | |
| (918) 775-3200 | |
| (918) 775-0080 |
| Full Name | Diamond Smiles Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1506 W Chickasaw Ave, Sallisaw, Oklahoma |
| Authorized Official Name and Position | Parley Melvin Hubler (PRESIDENT) |
| Authorized Official Contact | 9187753200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diamond Smiles Dental 1506 W Chickasaw Ave Sallisaw OK 74955-7200 Ph: (918) 775-3200 | Diamond Smiles Dental 1506 W Chickasaw Ave Sallisaw OK 74955-7200 Ph: (918) 775-3200 |
| NPI Number | 1669467270 |
|---|---|
| Provider Enumeration Date | 09/20/2005 |
| Last Update Date | 05/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669467270 | NPI | - | NPPES |
| 100091070A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5170 (Oklahoma) | Primary |
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