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General NPI Number Information
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NPI Number | 1558483040
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Entity Type | Organization
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Legal Business Name | JAMIE C. TALLEY, PC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 06/21/2010
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Provider Practice Location Address
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Address Line | 411 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-3207
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Country | US
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Telephone | 405-216-3434
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Fax | 405-216-3460
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Provider Business Mailing Address
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Address Line | 411 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-3207
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Country | US
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Telephone | 405-216-3434
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Fax | 405-216-3460
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Authorized Official
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Title or Position | DENTIST
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Name | DR. JAMIE CYNTHIA TALLEY
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Credential | D.D.S.
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Telephone | 405-216-3434
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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 | 5800
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License Number State | OK
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