NPI 1003196239
Dental Depot 62nd & South Western PLLC
Practice location
- Address
- 6217 S Western Ave, Oklahoma City, OK 73139-1605
- Phone
- (405) 606-7123
- Fax
- (405) 606-7130
- Mailing address
- 2828 NW 30th St, Oklahoma City, OK 73112-7404
Authorised official
- Name
- Glenn Allen Ashmore
- Title
- President
- Phone
- (405) 949-0123
Registered specialties
General Practice Dentistry
Primary
Registry record
- NPI
- 1003196239
- Entity type
- Organization
- NPI issued
- 19 Aug 2011
- Record last updated
- 25 Jun 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.