| On The Cusp Pediatric Dentistry, Pllc | |
|
8222 E 103rd St Ste 133 Tulsa OK 74133-7027 | |
| (918) 970-4944 | |
| (918) 970-4593 |
| Full Name | On The Cusp Pediatric Dentistry, Pllc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 8222 E 103rd St Ste 133, Tulsa, Oklahoma |
| Authorized Official Name and Position | Ryan Roberts (OWNER/MEMBER) |
| Authorized Official Contact | 9189704944 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| On The Cusp Pediatric Dentistry, Pllc 8222 E 103rd St 133 Tulsa OK 74133-7081 Ph: (918) 970-4944 | On The Cusp Pediatric Dentistry, Pllc 8222 E 103rd St Ste 133 Tulsa OK 74133-7027 Ph: (918) 970-4944 |
| NPI Number | 1114287091 |
|---|---|
| Provider Enumeration Date | 05/24/2012 |
| Last Update Date | 08/14/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114287091 | NPI | - | NPPES |
| 200258530A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
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