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General NPI Number Information
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NPI Number | 1407398977
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Entity Type | Organization
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Legal Business Name | PRISCILA J. JELSING, D.D.S., P.L.L.C.
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Dates
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Enumeration Date | 11/15/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 2106 S ATLANTA PL
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City | TULSA
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State | OK
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Zip | 74114
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Country | US
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Telephone | 918-743-7444
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 642
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City | HAZEN
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State | ND
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Zip | 58545
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Country | US
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Telephone | 918-671-8748
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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. PRISCILA JOY JELSING
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Credential | D.D.S.
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Telephone | 918-671-8748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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