Provider Demographics
NPI:1568097590
Name:DENTAL MASTERPIECES PLLC
Entity Type:Organization
Organization Name:DENTAL MASTERPIECES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PRISCILA
Authorized Official - Middle Name:
Authorized Official - Last Name:JELSING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-671-8748
Mailing Address - Street 1:3920 E 91ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-3602
Mailing Address - Country:US
Mailing Address - Phone:918-496-2481
Mailing Address - Fax:
Practice Address - Street 1:3920 E 91ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-3602
Practice Address - Country:US
Practice Address - Phone:918-496-2481
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-10
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental