Provider Demographics
NPI:1760630339
Name:DRUMRIGHT DENTAL CENTER, PLLC
Entity Type:Organization
Organization Name:DRUMRIGHT DENTAL CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:MELTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-352-3312
Mailing Address - Street 1:PO BOX 712
Mailing Address - Street 2:
Mailing Address - City:DRUMRIGHT
Mailing Address - State:OK
Mailing Address - Zip Code:74030-0712
Mailing Address - Country:US
Mailing Address - Phone:918-352-3312
Mailing Address - Fax:
Practice Address - Street 1:1226 W BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DRUMRIGHT
Practice Address - State:OK
Practice Address - Zip Code:74030-5826
Practice Address - Country:US
Practice Address - Phone:918-352-3312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK35731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty