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NPI Code Detail

MEDICARE: AASDG PLLC

MEDICARE: AASDG 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
1261QD0000XDental Clinic/Center
21223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1467180182
Entity Type Code : Organization
Provider Name (Legal Business Name) : AASDG PLLC
Provider Business Mailing Address
First Line : 13420 N PENNSYLVANIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-9007
Country : US
Telephone Number : 405-418-0888
Fax Number :
Provider Business Practice Location Address
First Line : 13400 N PENNSYLVANIA AVE
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73120-9007
Country : US
Telephone Number : 405-418-0888
Fax Number :
Authorized Official
Title or Position : OWNER
Name : JOSHUA BRASHER
Credential : DDS
Telephone Number : 405-474-6362
Provider Enumeration Date : 08/10/2022
Last Update Date : 09/17/2024

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