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General NPI Number Information
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NPI Number | 1265773071
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Entity Type | Organization
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Legal Business Name | CLINT PITT, D.D.S., P.C.
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Dates
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Enumeration Date | 03/05/2013
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Last Update Date | 03/14/2013
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Provider Practice Location Address
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Address Line | 1701 S MORGAN RD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73128-7005
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Country | US
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Telephone | 405-323-5366
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Fax |
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Provider Business Mailing Address
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Address Line | 3212 CHESTERFIELD PL
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City | OKLAHOMA CITY
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State | OK
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Zip | 73179-6009
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Country | US
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Telephone | 405-323-5366
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CLINT EUGENE PITT
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Credential | D.D.S.
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Telephone | 405-323-5366
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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 | 6207
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License Number State | OK
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