Provider Demographics
NPI:1568637262
Name:WARREN L. GOOD, D.D.S., P.C.
Entity Type:Organization
Organization Name:WARREN L. GOOD, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:GOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-743-6151
Mailing Address - Street 1:2112 S ATLANTA PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-1709
Mailing Address - Country:US
Mailing Address - Phone:918-743-6151
Mailing Address - Fax:918-743-6520
Practice Address - Street 1:2112 S ATLANTA PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1709
Practice Address - Country:US
Practice Address - Phone:918-743-6151
Practice Address - Fax:918-743-6520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty