MEDICARE: BROOKS SURGICAL ARTS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	5216	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316275951
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BROOKS SURGICAL ARTS, PLLC

Provider Business Mailing Address
First Line	:	3441 W ROCK CREEK RD
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73072-2435
Country	:	US
Telephone Number	:	405-329-3500
Fax Number	:	405-329-3501

Provider Business Practice Location Address
First Line	:	3441 W ROCK CREEK RD
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73072-2435
Country	:	US
Telephone Number	:	405-329-3500
Fax Number	:	405-329-3501

Authorized Official
Title or Position	:	OWNER
Name	:	MR. PERRY L BROOKS
Credential	:	DDS
Telephone Number	:	405-329-3500

Provider Enumeration Date	:	11/19/2009
Last Update Date	:	07/21/2022

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