Healthcare Provider Details

I. General information

NPI: 1053471466
Provider Name (Legal Business Name): STEVEN D MELTZNER D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 W MEMORIAL RD THE PLAZA #201
OKLAHOMA CITY OK
73120-8366
US

IV. Provider business mailing address

4140 W MEMORIAL RD THE PLAZA #201
OKLAHOMA CITY OK
73120-8366
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-4267
  • Fax: 405-749-4269
Mailing address:
  • Phone: 405-749-4267
  • Fax: 405-749-4269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3690
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: