Healthcare Provider Details

I. General information

NPI: 1366005159
Provider Name (Legal Business Name): NORMAN ENDODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2019
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 24TH AVE SW
NORMAN OK
73069-5110
US

IV. Provider business mailing address

410 24TH AVE SW
NORMAN OK
73069-5110
US

V. Phone/Fax

Practice location:
  • Phone: 405-307-8200
  • Fax: 405-307-8250
Mailing address:
  • Phone: 405-307-8200
  • Fax: 405-307-8250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: DR. STEVEN EUGENE POWELL
Title or Position: MANAGER
Credential: DDS
Phone: 405-307-8200