MEDICARE: DAVID WEBBER MERRELL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	121	OK

General Provider Information

NPI Number	:	1285913343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID WEBBER MERRELL DDS

Provider Business Mailing Address
First Line	:	930A W SHAWNEE ST
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401-3511
Country	:	US
Telephone Number	:	918-723-9931
Fax Number	:	918-723-9932

Provider Business Practice Location Address
First Line	:	930A W SHAWNEE ST
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401-3511
Country	:	US
Telephone Number	:	918-723-9931
Fax Number	:	918-723-9932

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2011
Last Update Date	:	03/17/2024

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Directions to “ DAVID WEBBER MERRELL DDS” Practice Location

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