Wilburton Family Dentistry, Llc | |
114 W Main St Wilburton OK 74578-4044 | |
(918) 465-2381 | |
Not Available |
Full Name | Wilburton Family Dentistry, Llc |
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Speciality | Dentist - General Practice |
Location | 114 W Main St, Wilburton, Oklahoma |
Authorized Official Name and Position | Casey Osterhout (PRESIDENT) |
Authorized Official Contact | 9184653535 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Wilburton Family Dentistry, Llc 114 W Main St Wilburton OK 74578-4044 Ph: (918) 465-2381 | Wilburton Family Dentistry, Llc 114 W Main St Wilburton OK 74578-4044 Ph: (918) 465-2381 |
NPI Number | 1518099357 |
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Provider Enumeration Date | 03/09/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1518099357 | NPI | - | NPPES |
1073676862 | Medicaid | OK |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 5805 (Oklahoma) | Primary |