| South Sooner Dental Partners | |
|
1060 Sw 4th St Ste 200 Moore OK 73160 | |
| (405) 384-7071 | |
| Not Available |
| Full Name | South Sooner Dental Partners |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1060 Sw 4th St Ste 200, Moore, Oklahoma |
| Authorized Official Name and Position | Tanner Prescott (DOCTOR) |
| Authorized Official Contact | 4053847071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Sooner Dental Partners 1060 Sw 4th St Ste 200 Moore OK 73160-2494 Ph: (405) 384-7071 | South Sooner Dental Partners 1060 Sw 4th St Ste 200 Moore OK 73160 Ph: (405) 384-7071 |
| NPI Number | 1316458383 |
|---|---|
| Provider Enumeration Date | 10/18/2017 |
| Last Update Date | 09/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316458383 | NPI | - | NPPES |
| 1629595046 | Other | DOCTOR NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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