Provider Demographics
NPI:1992930523
Name:METZ, AUGUST IV (DMD)
Entity type:Individual
Prefix:DR
First Name:AUGUST
Middle Name:
Last Name:METZ
Suffix:IV
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3323 WIEHLE ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19129-1751
Mailing Address - Country:US
Mailing Address - Phone:570-604-6598
Mailing Address - Fax:
Practice Address - Street 1:1829 S WOOD DR
Practice Address - Street 2:
Practice Address - City:OKMULGEE
Practice Address - State:OK
Practice Address - Zip Code:74447-6825
Practice Address - Country:US
Practice Address - Phone:918-756-6500
Practice Address - Fax:918-756-6505
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-27
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK78171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice