Healthcare Provider Details

I. General information

NPI: 1437163284
Provider Name (Legal Business Name): MICHAEL J. HOSIER, DDS, MS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 S TOLEDO AVE
TULSA OK
74137-2719
US

IV. Provider business mailing address

9101 S TOLEDO AVE
TULSA OK
74137-2719
US

V. Phone/Fax

Practice location:
  • Phone: 918-523-4999
  • Fax: 918-477-7497
Mailing address:
  • Phone: 918-523-4999
  • Fax: 918-477-7497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number5228
License Number StateOK

VIII. Authorized Official

Name: DR. MICHAEL JOHN HOSIER
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 918-523-4999