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NPI Code Detail

MEDICARE: SHERMAN J. MENSER D.D.S

MEDICARE: SHERMAN J. MENSER D.D.S
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
1122300000XDentist5183OK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11831134295OTHEROKTYPE I NPI

General Provider Information

NPI Number : 1609042910
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHERMAN J. MENSER D.D.S
Provider Business Mailing Address
First Line : 2809 SHADYBROOK DR
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-3121
Country : US
Telephone Number : 405-737-3441
Fax Number :
Provider Business Practice Location Address
First Line : 2809 SHADYBROOK DR
Second Line :
City : MIDWEST CITY
State : OK
Zip : 73110-3121
Country : US
Telephone Number : 405-737-3441
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : TANYA L RODGERS
Credential :
Telephone Number : 405-737-3441
Provider Enumeration Date : 05/06/2008
Last Update Date : 05/06/2008

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Directions to “SHERMAN J. MENSER D.D.S ” Practice Location

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