| Smile Galaxy Pediatric Dentistry | |
|
9801 S. Pennsylvania Oklahoma City OK 73159-6925 | |
| (405) 692-1222 | |
| (405) 703-0930 |
| Full Name | Smile Galaxy Pediatric Dentistry |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9801 S. Pennsylvania, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Robert Brian Molloy (BUSINESS OWNER) |
| Authorized Official Contact | 4056921222 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile Galaxy Pediatric Dentistry Po Box 892290 Oklahoma City OK 73189-2290 Ph: (405) 692-1222 | Smile Galaxy Pediatric Dentistry 9801 S. Pennsylvania Oklahoma City OK 73159-6925 Ph: (405) 692-1222 |
| NPI Number | 1023034451 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 11/07/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023034451 | NPI | - | NPPES |
| 200066610A | Medicaid | OK | |
| 1390128 | Other | UNITED CONCORDIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 5436 (Oklahoma) | Primary |
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› Verified 8 days ago
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