| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 500 N Eastern Ave, Moore, Oklahoma |
| Authorized Official Name and Position | Richard M Freeman (PRESIDENT) |
| Authorized Official Contact | 4059123300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
500 N Eastern Ave Moore OK 76160 Ph: (405) 912-3300 | 500 N Eastern Ave Moore OK 76160 Ph: (405) 912-3300 |
| NPI Number | 1114912649 |
|---|---|
| Provider Enumeration Date | 09/12/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114912649 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5546 (Oklahoma) | Primary |
| 1223G0001X | Dentist - General Practice | 5693 (Oklahoma) | Secondary |
Mahant Dental Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1112 Sw 30th Ct Ste 105, Moore, OK 73160 Phone: 405-979-0511 | |
J J Richardson Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 840 Se 4th St, Suite 3a, Moore, OK 73160 Phone: 405-799-7071 | |
Dental Depot Orthodontics Moore, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 2709 S I 35 Frontage Rd Ste A, Moore, OK 73160 Phone: 405-957-5440 Fax: 405-957-5542 | |
Chad D Spiva Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 808 Ne 19th St, Moore, OK 73160 Phone: 405-799-5529 Fax: 405-799-8223 | |