| Smilesoftulsa.com | |
|
6565 S Yale Ave Ste 1103 Tulsa OK 74136-8327 | |
| (918) 481-4910 | |
| (918) 481-4917 |
| Full Name | Smilesoftulsa.com |
|---|---|
| Speciality | Dentist |
| Location | 6565 S Yale Ave Ste 1103, Tulsa, Oklahoma |
| Authorized Official Name and Position | Corbyn Lee Vanbrunt (DENTIST) |
| Authorized Official Contact | 9184814910 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smilesoftulsa.com 6565 S Yale Ave Ste 1103 Tulsa OK 74136-8327 Ph: (918) 481-4910 | Smilesoftulsa.com 6565 S Yale Ave Ste 1103 Tulsa OK 74136-8327 Ph: (918) 481-4910 |
| NPI Number | 1871587832 |
|---|---|
| Provider Enumeration Date | 09/07/2005 |
| Last Update Date | 07/03/2020 |
| Medicare PECOS PAC ID | 7315373800 |
|---|---|
| Medicare Enrollment ID | O20200131000582 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871587832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5445 (Oklahoma) | Primary |
| Provider Name | Corbyn L Vanbrunt |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1306868492 PECOS PAC ID: 5496181984 Enrollment ID: I20200131000697 |
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