| North Lake Dental Pllc | |
|
12200 N Macarthur Blvd Ste 1 Oklahoma City OK 73162-1849 | |
| (918) 998-0996 | |
| Not Available |
| Full Name | North Lake Dental Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12200 N Macarthur Blvd Ste 1, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Candice Schumann (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9189980996 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Lake Dental Pllc 400 Riverwalk Ter Ste 250 Jenks OK 74037-5619 Ph: (918) 998-0996 | North Lake Dental Pllc 12200 N Macarthur Blvd Ste 1 Oklahoma City OK 73162-1849 Ph: (918) 998-0996 |
| NPI Number | 1891472304 |
|---|---|
| Provider Enumeration Date | 06/28/2023 |
| Last Update Date | 06/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891472304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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