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General NPI Number Information
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NPI Number | 1760498448
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Entity Type | Individual
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Provider Name | LINDA LOU MINER D.M.D
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Gender | Female
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 1145 W I 240 SERVICE RD STE D
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-2134
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Country | US
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Telephone | 405-631-3877
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Fax | 405-631-7414
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Provider Business Mailing Address
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Address Line | 1145 W I 240 SERVICE RD STE D
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-2134
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Country | US
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Telephone | 405-631-3877
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Fax | 405-631-7414
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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 | 952
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License Number State | OK
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