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General NPI Number Information
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NPI Number | 1366068108
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Entity Type | Individual
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Provider Name | MERIDITH TINNIN DDS
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Gender | Female
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Dates
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Enumeration Date | 06/17/2020
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Last Update Date | 07/08/2020
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Provider Practice Location Address
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Address Line | 221 E 7TH AVE
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City | BRISTOW
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State | OK
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Zip | 74010-2503
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Country | US
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Telephone | 918-367-3290
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Fax | 918-367-6446
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Provider Business Mailing Address
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Address Line | 221 E 7TH AVE
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City | BRISTOW
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State | OK
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Zip | 74010-2503
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Country | US
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Telephone | 918-367-3290
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Fax | 918-367-6446
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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 | T-7325
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7325
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License Number State | OK
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