| Idental Pllc | |
|
1700 S Sunnylane Rd Oklahoma City OK 73115-3118 | |
| (405) 670-5000 | |
| (405) 670-5001 |
| Full Name | Idental Pllc |
|---|---|
| Speciality | Dentist |
| Location | 1700 S Sunnylane Rd, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Toby Rhodes (DENTIST) |
| Authorized Official Contact | 4058307988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Idental Pllc 1700 S Sunnylane Rd Oklahoma City OK 73115-3118 Ph: (405) 670-5000 | Idental Pllc 1700 S Sunnylane Rd Oklahoma City OK 73115-3118 Ph: (405) 670-5000 |
| NPI Number | 1932552080 |
|---|---|
| Provider Enumeration Date | 07/13/2016 |
| Last Update Date | 07/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932552080 | NPI | - | NPPES |
| 200252070A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6138 (Oklahoma) | Primary |
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