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General NPI Number Information
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NPI Number | 1003082132
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Entity Type | Organization
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Legal Business Name | NEIGHBORHOOD SERVICES ORGANIZATION INC
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Dates
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Enumeration Date | 05/08/2008
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Last Update Date | 05/08/2008
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Provider Practice Location Address
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Address Line | 431 SW 11TH STREET
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-5613
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Country | US
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Telephone | 405-236-0413
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Fax | 405-236-1871
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Provider Business Mailing Address
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Address Line | 431 SW 11TH STREET
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City | OKLAHOMA CITY
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State | OK
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Zip | 73109-5613
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Country | US
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Telephone | 405-236-0413
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Fax | 405-236-1871
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. STACEY ANNE NINNESS
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Credential |
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Telephone | 405-236-0413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 4480
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 3065
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2302
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License Number State | OK
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