Provider Demographics
NPI:1346073137
Name:DENTAL ARTS OF SOUTH TULSA, LLC
Entity type:Organization
Organization Name:DENTAL ARTS OF SOUTH TULSA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WEAST
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:918-798-6903
Mailing Address - Street 1:9999 S MINGO RD STE S
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5172
Mailing Address - Country:US
Mailing Address - Phone:918-524-4000
Mailing Address - Fax:
Practice Address - Street 1:9999 S MINGO RD STE S
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5172
Practice Address - Country:US
Practice Address - Phone:918-524-4000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental