OrganizationActive
Eastern Oklahoma Oral and Maxillofacial Surgeons
NPI 1487074704 · Oral and Maxillofacial Surgery (Dentist) · Broken Arrow, OK
Provider details
- NPI number
- 1487074704
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Authorized official
- Angie Roe, Credentialing and Contracting
Practice location
4716 W Urbana St
Broken Arrow, OK 74012-5997
Phone: (918) 449-5800
Fax: (918) 455-8958
Mailing address
4716 W Urbana St
Broken Arrow, OK 74012-5997
Registry dates
- Enumerated
- 2014-04-25
- Last updated
- 2018-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.