| East 111 Family Dentistry Pllc | |
|
8194 E 111th St S Bixby OK 74008-2421 | |
| (918) 369-6118 | |
| Not Available |
| Full Name | East 111 Family Dentistry Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 8194 E 111th St S, Bixby, Oklahoma |
| Authorized Official Name and Position | Faith Gaskins (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 9728693789 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| East 111 Family Dentistry Pllc 8194 E 111th St S Bixby OK 74008-2421 Ph: (918) 369-6118 | East 111 Family Dentistry Pllc 8194 E 111th St S Bixby OK 74008-2421 Ph: (918) 369-6118 |
| NPI Number | 1649881582 |
|---|---|
| Provider Enumeration Date | 08/13/2020 |
| Last Update Date | 08/13/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649881582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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