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12150 E 96th St N Suite 106 Owasso OK 74055-5338 | |
| (918) 272-0707 | |
| (918) 272-0709 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12150 E 96th St N, Owasso, Oklahoma |
| Authorized Official Name and Position | Michael Phillip Sanchez (DENTIST OWNER) |
| Authorized Official Contact | 9182720707 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12150 E 96th St N Suite 106 Owasso OK 74055-5338 Ph: (918) 272-0707 | 12150 E 96th St N Suite 106 Owasso OK 74055-5338 Ph: (918) 272-0707 |
| NPI Number | 1073789293 |
|---|---|
| Provider Enumeration Date | 05/07/2008 |
| Last Update Date | 05/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073789293 | NPI | - | NPPES |
| 1952396137 | Other | OK | TYPE 1 NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5330 (Oklahoma) | Primary |
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