Provider Demographics
NPI:1225297518
Name:ACCESS DENTAL, PLLC
Entity Type:Organization
Organization Name:ACCESS DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:BATTLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-343-2300
Mailing Address - Street 1:1222 N FLORENCE AVE
Mailing Address - Street 2:STE F
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017-3147
Mailing Address - Country:US
Mailing Address - Phone:918-343-2300
Mailing Address - Fax:918-342-8820
Practice Address - Street 1:1222 N FLORENCE AVE
Practice Address - Street 2:STE F
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-3147
Practice Address - Country:US
Practice Address - Phone:918-343-2300
Practice Address - Fax:918-342-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5778261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200068010-AMedicaid