Lavalley Dental Care, Inc. | |
300 E Highway St Holdenville OK 74848-4060 | |
(405) 379-2700 | |
Not Available |
Full Name | Lavalley Dental Care, Inc. |
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Speciality | Dentist |
Location | 300 E Highway St, Holdenville, Oklahoma |
Authorized Official Name and Position | Renee Lynnette Lavalley (PRESIDENT) |
Authorized Official Contact | 4053792700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Lavalley Dental Care, Inc. 300 E Highway St Holdenville OK 74848-4060 Ph: (405) 379-2700 | Lavalley Dental Care, Inc. 300 E Highway St Holdenville OK 74848-4060 Ph: (405) 379-2700 |
NPI Number | 1740455674 |
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Provider Enumeration Date | 04/22/2008 |
Last Update Date | 04/22/2008 |
Identifier | Type | State | Issuer |
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1740455674 | NPI | - | NPPES |
100097210A | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
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122300000X | Dentist | 5172 (Oklahoma) | Primary |
Phil Tyree Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 N Hinckley St, Holdenville, OK 74848 Phone: 405-379-6695 Fax: 405-379-6923 |