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Contact Information

PREMIERE DENTISTRY OF TAHLEQUAH
1205 E ROSS BYPASS
TAHLEQUAH, OK74464
 Phone: 918-456-2555
 Fax: 918-456-2444
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for PREMIERE DENTISTRY OF TAHLEQUAH

NPI Number 1245299825
LBN Legal business name PREMIERE DENTISTRY OF TAHLEQUAH
Authorized official ROBERT JONES - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 03/21/2006
Last updated 04/06/2010 - About 16 years ago
Identifiers
OK Medicaid 200021320
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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