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General NPI Number Information
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NPI Number | 1245468602
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Entity Type | Organization
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Legal Business Name | ZACHARY D. MOFFITT, DDS, PLLC
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 333 E. ETOWAH RD
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City | NOBLE
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State | OK
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Zip | 73068
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Country | US
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Telephone | 405-872-0440
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Fax | 405-872-0442
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Provider Business Mailing Address
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Address Line | PO BOX 7
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City | NOBLE
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State | OK
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Zip | 73068
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Country | US
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Telephone | 405-872-0440
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Fax | 405-872-0442
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Authorized Official
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Title or Position | SOLE MEMBER/PRESIDENT/DENTIST
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Name | DR. ZACHARY DODE MOFFITT
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Credential |
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Telephone | 405-872-0440
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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 |
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