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General NPI Number Information
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NPI Number | 1629110119
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Entity Type | Organization
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Legal Business Name | BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA - OU DENITSTRY
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 1201 N STONEWALL ROOM 494
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1214
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Country | US
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Telephone | 405-271-5714
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Fax | 405-271-2405
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Provider Business Mailing Address
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Address Line | 1201 N STONEWALL AVE RM 321
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City | OKLAHOMA CITY
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State | OK
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Zip | 73117-1214
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Country | US
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Telephone | 405-271-8001
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Fax | 405-271-2922
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Authorized Official
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Title or Position | DIRECTOR
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Name | D. MICHELLE PARK
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Credential |
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Telephone | 405-271-8001
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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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