Healthcare Provider Details

I. General information

NPI: 1154351500
Provider Name (Legal Business Name): WAYNE SCOTT HARRINGTON DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2111 S ATLANTA PL
TULSA OK
74114-1709
US

IV. Provider business mailing address

2111 S ATLANTA PL
TULSA OK
74114-1709
US

V. Phone/Fax

Practice location:
  • Phone: 918-743-9929
  • Fax: 918-743-1546
Mailing address:
  • Phone: 918-743-9929
  • Fax: 918-743-1546

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number3666
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: