Southard Family Dental, Llc | |
6333 S Memorial Dr Tulsa OK 74133-1948 | |
(918) 294-1144 | |
Not Available |
Full Name | Southard Family Dental, Llc |
---|---|
Speciality | Dentist |
Location | 6333 S Memorial Dr, Tulsa, Oklahoma |
Authorized Official Name and Position | Loren Paul Israelsen (CEO) |
Authorized Official Contact | 2757730432 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Southard Family Dental, Llc 6333 S Memorial Dr Tulsa OK 74133-1948 Ph: (918) 294-1144 | Southard Family Dental, Llc 6333 S Memorial Dr Tulsa OK 74133-1948 Ph: (918) 294-1144 |
NPI Number | 1366103244 |
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Provider Enumeration Date | 01/04/2022 |
Last Update Date | 09/06/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1366103244 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
News Archive
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