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General NPI Number Information
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NPI Number | 1619820719
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Entity Type | Organization
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Legal Business Name | PEDIATRIC DENTAL SERVICES OF OKLAHOMA PLLC
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Dates
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Enumeration Date | 02/18/2026
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Last Update Date | 02/18/2026
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Provider Practice Location Address
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Address Line | 550 NE 24TH ST STE G
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City | NEWCASTLE
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State | OK
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Zip | 73065-6364
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Country | US
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Telephone | 801-201-8396
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Fax |
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Provider Business Mailing Address
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Address Line | 10157 STONE GATE WAY
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City | ARCADIA
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State | OK
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Zip | 73007-7529
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Country | US
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Telephone | 801-201-8396
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DR. DAVID EVANS
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Credential | DMD
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Telephone | 801-201-8396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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