| Vic H. Trammell Dmd, Pc | |
|
2950 S Elm Pl Suite 340 Broken Arrow OK 74012-7877 | |
| (918) 451-0944 | |
| (918) 455-8598 |
| Full Name | Vic H. Trammell Dmd, Pc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2950 S Elm Pl, Broken Arrow, Oklahoma |
| Authorized Official Name and Position | Julia E Sams (CONTRACT COORDINATOR) |
| Authorized Official Contact | 9184948634 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vic H. Trammell Dmd, Pc 2950 S Elm Pl Suite 340 Broken Arrow OK 74012-7877 Ph: (918) 451-0944 | Vic H. Trammell Dmd, Pc 2950 S Elm Pl Suite 340 Broken Arrow OK 74012-7877 Ph: (918) 451-0944 |
| NPI Number | 1265756308 |
|---|---|
| Provider Enumeration Date | 03/18/2010 |
| Last Update Date | 03/18/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265756308 | NPI | - | NPPES |
| 100185040A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4676 (Oklahoma) | Primary |
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