Sudberry Dental

LBN: Sudberry Dental
Sudberry Dental is an health care organization with primary practice located at 1520 N Commerce St Ste A , Ardmore OK 73401-1858. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Sudberry Dental can be contacted via phone (580) 226-1515, or through Sudberry, Thomas Blake via phone (580) 226-1515.

Contact Information

Primary practice address
1520 N Commerce St Ste A Ardmore OK 73401-1858
Phone: (580) 226-1515
Fax: (580) 226-1516
Website:
Map and Directions
Authorized official contact:
Name: Sudberry, Thomas Blake Doctor of Dental Surgery (DDS)
Phone: (580) 226-1515

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5443 Oklahoma

Profile Details

NPI number 1962798595
LBN Legal business name Sudberry Dental
DBA Doing business as
Authorized official Sudberry, Thomas Blake Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 22nd, 2011
Last updated Jun 22nd, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962798595 NPPES
Oklahoma MEDICAID 1801081534

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