MEDICARE: DENTAL OASIS, PLLC

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	1223G0001X	General Practice Dentistry	27319	TX

General Provider Information

NPI Number	:	1982043436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL OASIS, PLLC

Provider Business Mailing Address
First Line	:	600 CUT OFF RD
Second Line	:	SUITE 2
City	:	PORT ARANSAS
State	:	TX
Zip	:	78373-4245
Country	:	US
Telephone Number	:	361-749-1992
Fax Number	:	361-749-1993

Provider Business Practice Location Address
First Line	:	600 CUT OFF RD
Second Line	:	SUITE 2
City	:	PORT ARANSAS
State	:	TX
Zip	:	78373-4245
Country	:	US
Telephone Number	:	361-749-1992
Fax Number	:	361-749-1993

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. CHRISTOPHER KIGHT
Credential	:	D.M.D.
Telephone Number	:	361-749-1992

Provider Enumeration Date	:	06/18/2013
Last Update Date	:	06/18/2013

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