Healthcare Provider Details

I. General information

NPI: 1801219225
Provider Name (Legal Business Name): STEVEN D. MELTZNER, DMD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2014
Last Update Date: 01/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4140 W MEMORIAL RD SUITE 201
OKLAHOMA CITY OK
73120-8366
US

IV. Provider business mailing address

4140 W MEMORIAL RD SUITE 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: DR. STEVEN D. MELTZNER
Title or Position: MANAGING PARTNER
Credential: DMD, PLLC
Phone: 310-800-5797