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13101 E. 96th Street North Owasso OK 74055-4775 | |
| (918) 928-4747 | |
| (918) 928-4748 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 13101 E. 96th Street North, Owasso, Oklahoma |
| Authorized Official Name and Position | Jennifer Hoelscher (INSURANCE/CREDENTIALING) |
| Authorized Official Contact | 2175405100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
13101 E. 96th Street North Owasso OK 74055-4775 Ph: (918) 928-4747 | 13101 E. 96th Street North Owasso OK 74055-4775 Ph: (918) 928-4747 |
| NPI Number | 1437568730 |
|---|---|
| Provider Enumeration Date | 08/12/2014 |
| Last Update Date | 08/12/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437568730 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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