Provider Demographics
NPI:1952441289
Name:OCEAN DENTAL, PC
Entity Type:Organization
Organization Name:OCEAN DENTAL, PC
Other - Org Name:STAR DENTAL
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:B
Authorized Official - Last Name:HOECKER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-707-0600
Mailing Address - Street 1:206 W 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4017
Mailing Address - Country:US
Mailing Address - Phone:405-707-0600
Mailing Address - Fax:405-707-0602
Practice Address - Street 1:3919 N MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:WARR ACRES
Practice Address - State:OK
Practice Address - Zip Code:73122-2005
Practice Address - Country:US
Practice Address - Phone:405-787-7827
Practice Address - Fax:405-470-1838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty