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General NPI Number Information
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NPI Number | 1346939253
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Entity Type | Individual
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Provider Name | DREXY PEARL TORRES ANCOG DDS
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Gender | Female
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Dates
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Enumeration Date | 05/05/2023
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 1040 NE 36TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73111-5002
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Country | US
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Telephone | 405-967-7742
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Fax |
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Provider Business Mailing Address
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Address Line | 13208 SAWTOOTH OAK RD
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City | CHOCTAW
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State | OK
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Zip | 73020-2156
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Country | US
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Telephone | 405-248-7026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 7743
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License Number State | OK
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