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General NPI Number Information
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NPI Number | 1083598999
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Entity Type | Organization
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Legal Business Name | DENTAL ARTS OF PRYOR, LLC
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Dates
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Enumeration Date | 08/04/2025
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 137 STEVE BARRY BLVD
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City | PRYOR
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State | OK
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Zip | 74361-6841
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Country | US
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Telephone | 918-212-4009
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Fax | 918-212-4033
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Provider Business Mailing Address
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Address Line | 6463 N INDIGO TRL
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City | OWASSO
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State | OK
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Zip | 74055-7578
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Country | US
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Telephone | 918-812-1287
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | STEPHEN BULLEIGH
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Credential | JD
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Telephone | 918-812-1287
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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