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General NPI Number Information
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NPI Number | 1245023399
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Entity Type | Organization
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Legal Business Name | SUNSHINE SMILES PLLC
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 427 STONE WOOD DR STE 427
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City | BROKEN ARROW
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State | OK
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Zip | 74012-1026
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Country | US
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Telephone | 918-364-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 6632 S MEMORIAL DR
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City | TULSA
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State | OK
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Zip | 74133-2050
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Country | US
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Telephone | 918-364-2222
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Fax |
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Authorized Official
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Title or Position | OWNER/ PARTNER
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Name | MARTIN F TROCKEL
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Credential | MS, DDS
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Telephone | 801-319-0603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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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 |
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License Number State |
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