Renaissance Dental | |
12150 E 96th St N Suite 106 Owasso OK 74055-5338 | |
(918) 272-0707 | |
(918) 272-0709 |
Full Name | Renaissance Dental |
---|---|
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 |
---|---|
Renaissance Dental 12150 E 96th St N Suite 106 Owasso OK 74055-5338 Ph: (918) 272-0707 | Renaissance Dental 12150 E 96th St N Suite 106 Owasso OK 74055-5338 Ph: (918) 272-0707 |
NPI Number | 1073789293 |
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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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