Provider Demographics
NPI:1790007151
Name:DR. COLPITTS WELLNESS CENTER
Entity Type:Organization
Organization Name:DR. COLPITTS WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:COLPITTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-477-9000
Mailing Address - Street 1:2448 E 81ST ST
Mailing Address - Street 2:SUITE 1600
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4250
Mailing Address - Country:US
Mailing Address - Phone:918-477-9000
Mailing Address - Fax:918-477-9056
Practice Address - Street 1:2448 E 81ST ST
Practice Address - Street 2:SUITE 1600
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4250
Practice Address - Country:US
Practice Address - Phone:918-477-9000
Practice Address - Fax:918-477-9056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty