| Southeast Oklahoma Oral & Maxillofacial Surgery, Pc | |
|
803 N Monte Vista St Ada OK 74820-7711 | |
| (580) 332-3010 | |
| (580) 332-3010 |
| Full Name | Southeast Oklahoma Oral & Maxillofacial Surgery, Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 803 N Monte Vista St, Ada, Oklahoma |
| Authorized Official Name and Position | R. Todd Boone (ORAL SURGEON AND OWNER) |
| Authorized Official Contact | 5803323010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southeast Oklahoma Oral & Maxillofacial Surgery, Pc 803 N Monte Vista St Ada OK 74820-7711 Ph: (580) 332-3010 | Southeast Oklahoma Oral & Maxillofacial Surgery, Pc 803 N Monte Vista St Ada OK 74820-7711 Ph: (580) 332-3010 |
| NPI Number | 1306839246 |
|---|---|
| Provider Enumeration Date | 08/25/2005 |
| Last Update Date | 05/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306839246 | NPI | - | NPPES |
| 444583300004 | Other | OK | BCBS |
| 444583300003 | Other | OK | BCBS |
| 787600 | Other | OK | UNITED CONCORDIA |
| 100112550A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Brian D. Coerver, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1401 Arlington St, Ada, OK 74820 Phone: 580-332-4872 Fax: 580-436-1971 | |
Nova Oral Surgery Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 803 N Monte Vista St, Ada, OK 74820 Phone: 580-332-3010 Fax: 580-332-3010 | |
Ada Dentistry And Braces Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 931 Arlington St Ste 3, Ada, OK 74820 Phone: 580-332-0431 | |
Central Oklahoma Family Medical Center Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 304 N Monte Vista Street, Ada, OK 74820 Phone: 580-436-5111 Fax: 580-925-9147 | |
Ada Smile Place, Pllc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1801 Arlington St, Ada, OK 74820 Phone: 580-332-1660 Fax: 580-421-9009 | |
Mark W Weems Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 S Rennie St, Ada, OK 74820 Phone: 580-332-9447 |