Healthcare Provider Details

I. General information

NPI: 1679769988
Provider Name (Legal Business Name): OCEAN DENTAL, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 12/03/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 N. MAIN SUITE 200
NORMAN OK
73069-7061
US

IV. Provider business mailing address

206 W 6TH AVE
STILLWATER OK
74074-4017
US

V. Phone/Fax

Practice location:
  • Phone: 405-321-2349
  • Fax:
Mailing address:
  • Phone: 405-707-0600
  • Fax: 405-707-0601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHAD BRANDON HOECKER
Title or Position: OWNER
Credential: DDS
Phone: 405-707-0600