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General NPI Number Information
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NPI Number | 1235560194
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Entity Type | Organization
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Legal Business Name | D-LINK DENTAL NETWORK
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Dates
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Enumeration Date | 12/03/2013
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Last Update Date | 12/03/2013
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Provider Practice Location Address
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Address Line | 1647 E 61ST ST
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City | TULSA
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State | OK
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Zip | 74136-0712
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Country | US
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Telephone | 888-748-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 1647 E 61ST ST
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City | TULSA
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State | OK
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Zip | 74136-0712
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Country | US
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Telephone | 888-748-3990
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. RICHARD DAIL DAUGHTRY
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Credential |
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Telephone | 405-227-7354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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