Provider Demographics
NPI:1962677898
Name:GEORGE R. SAFLEY D.D.S., INC.
Entity Type:Organization
Organization Name:GEORGE R. SAFLEY D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:SAFLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-794-6066
Mailing Address - Street 1:101 NE 18TH ST
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-4601
Mailing Address - Country:US
Mailing Address - Phone:405-794-6066
Mailing Address - Fax:405-794-4060
Practice Address - Street 1:101 NE 18TH ST
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-4601
Practice Address - Country:US
Practice Address - Phone:405-794-6066
Practice Address - Fax:405-794-4060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK31331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty