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NPI 1831365428

NPI 1831365428 : CHARLES T. EILER, INC. : TULSA, OK

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General NPI Number Information
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    NPI Number           |    1831365428
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    Entity Type          |    Organization 
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    Legal Business Name  |    CHARLES T. EILER, INC. 
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Dates
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    Enumeration Date     |    05/02/2008
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    Last Update Date     |    05/02/2008
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Provider Practice Location Address
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    Address Line         |    8026 S MEMORIAL DR 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74133-3644
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    Country              |    US
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    Telephone            |    918-250-9288
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    Fax                  |    918-250-8171
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Provider Business Mailing Address
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    Address Line         |    8026 S MEMORIAL DR 
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    City                 |    TULSA
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    State                |    OK
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    Zip                  |    74133-3644
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    Country              |    US
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    Telephone            |    918-250-9288
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    Fax                  |    918-250-8171
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. CHARLES T. EILER 
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    Credential           |    D.M.D.
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    Telephone            |    918-250-9288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QD0000X
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    Taxonomy Name        |    Dental Clinic/Center
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    License Number       |    5000
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    License Number State |    OK
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