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General NPI Number Information
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NPI Number | 1164815395
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Entity Type | Organization
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Legal Business Name | JOHN F CARLETTI DDS PROF CORP
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 2808 E. 101ST ST.
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City | TULSA
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State | OK
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Zip | 74137
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Country | US
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Telephone | 918-299-5399
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Fax | 918-299-5842
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Provider Business Mailing Address
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Address Line | 635 S. MAIN
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City | SAPULPA
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State | OK
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Zip | 74066
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Country | US
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Telephone | 918-299-5399
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Fax | 918-299-5842
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Authorized Official
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Title or Position | CFO
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Name | KAREN SUMMERS
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Credential |
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Telephone | 918-299-5399
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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 |
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License Number State | OK
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