Provider Demographics
NPI:1518494384
Name:UPTOWN SMILES PLLC
Entity Type:Organization
Organization Name:UPTOWN SMILES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARICRUZ
Authorized Official - Middle Name:S
Authorized Official - Last Name:MARTINZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:254-214-5039
Mailing Address - Street 1:2905 BROOKSTONE CT
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-5018
Mailing Address - Country:US
Mailing Address - Phone:254-214-5039
Mailing Address - Fax:
Practice Address - Street 1:601 NW 23RD ST
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1415
Practice Address - Country:US
Practice Address - Phone:254-214-5039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6832261QD0000X
OK6142261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental