| Sudberry Dental | |
|
1520 N Commerce St Ste A Ardmore OK 73401-1858 | |
| (580) 226-1515 | |
| (580) 226-1516 |
| Full Name | Sudberry Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1520 N Commerce St Ste A, Ardmore, Oklahoma |
| Authorized Official Name and Position | Thomas Blake Sudberry (DENTIIST) |
| Authorized Official Contact | 5802261515 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sudberry Dental 1520 N Commerce St Ste A Ardmore OK 73401-1858 Ph: (580) 226-1515 | Sudberry Dental 1520 N Commerce St Ste A Ardmore OK 73401-1858 Ph: (580) 226-1515 |
| NPI Number | 1962798595 |
|---|---|
| Provider Enumeration Date | 06/22/2011 |
| Last Update Date | 06/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962798595 | NPI | - | NPPES |
| 1801081534 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 5443 (Oklahoma) | Primary |
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