Provider Demographics
NPI:1275854846
Name:PITT, CLINT EUGENE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLINT
Middle Name:EUGENE
Last Name:PITT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 S MORGAN RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73128-7005
Mailing Address - Country:US
Mailing Address - Phone:405-494-7799
Mailing Address - Fax:
Practice Address - Street 1:1701 S MORGAN RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73128-7005
Practice Address - Country:US
Practice Address - Phone:405-494-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK62071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice