| Ou Childrens Physicians Dental Service-oucp Dental Service | |
|
1200 Childrens Ave Ste 8f Oklahoma City OK 73104-4637 | |
| (405) 271-4750 | |
| (405) 271-4055 |
| Full Name | Ou Childrens Physicians Dental Service-oucp Dental Service |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1200 Childrens Ave Ste 8f, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | David Alan Ciesla (PROGRAM DIRECTOR) |
| Authorized Official Contact | 4052714750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ou Childrens Physicians Dental Service-oucp Dental Service 1200 Childrens Ave Ste 8f Oklahoma City OK 73104-4637 Ph: (405) 271-4750 | Ou Childrens Physicians Dental Service-oucp Dental Service 1200 Childrens Ave Ste 8f Oklahoma City OK 73104-4637 Ph: (405) 271-4750 |
| NPI Number | 1013938117 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 05/16/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013938117 | NPI | - | NPPES |
| 100749330A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Oklahoma) | Primary |
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Wm Edward Holcomb Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6303 North Portland Ave #209, Oklahoma City, OK 73112 Phone: 405-942-7771 Fax: 405-942-7796 | |
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Heather Cox Dds Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 5701 N Portland Ave, Suite 121, Oklahoma City, OK 73112 Phone: 405-604-6400 Fax: 405-604-4229 | |
Dental Depot 62nd & South Western Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6217 S Western Ave, Oklahoma City, OK 73139 Phone: 405-606-7123 Fax: 405-606-7130 | |
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