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General NPI Number Information
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NPI Number | 1023798709
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Entity Type | Organization
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Legal Business Name | WOODWARD ORAL SURGERY LLC
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Dates
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Enumeration Date | 07/19/2023
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 4617 E 91ST ST
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City | TULSA
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State | OK
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Zip | 74137-2852
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Country | US
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Telephone | 918-492-6994
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Fax |
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Provider Business Mailing Address
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Address Line | 4617 E 91ST ST
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City | TULSA
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State | OK
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Zip | 74137-2852
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Country | US
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Telephone | 918-492-6994
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. JOSHUA WOODWARD
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Credential | DDS
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Telephone | 918-260-0012
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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