Provider Demographics
NPI:1821263567
Name:RICHARD S. HOMSEY D.S.S. INC
Entity Type:Organization
Organization Name:RICHARD S. HOMSEY D.S.S. INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:HOMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-794-4497
Mailing Address - Street 1:1400 S.E. 4TH
Mailing Address - Street 2:SUITE A
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160
Mailing Address - Country:US
Mailing Address - Phone:405-794-4497
Mailing Address - Fax:
Practice Address - Street 1:1400 S.E. 4TH
Practice Address - Street 2:SUITE A
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160
Practice Address - Country:US
Practice Address - Phone:405-794-4497
Practice Address - Fax:
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 Licenses
StateLicense IDTaxonomies
OK35501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty