Provider Demographics
NPI:1922360783
Name:TRAMMELL, VIC HILL JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIC
Middle Name:HILL
Last Name:TRAMMELL
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8819 N 145TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-8464
Mailing Address - Country:US
Mailing Address - Phone:918-272-5381
Mailing Address - Fax:918-274-0815
Practice Address - Street 1:8819 N 145TH EAST AVE
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-8464
Practice Address - Country:US
Practice Address - Phone:918-272-5381
Practice Address - Fax:918-274-0815
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2016-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK64101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice