Provider Demographics
NPI:1992196067
Name:ROO DENTAL PLLC
Entity Type:Organization
Organization Name:ROO DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:GAIL
Authorized Official - Last Name:WOOLFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:940-393-2928
Mailing Address - Street 1:252 PRIVATE ROAD 4574
Mailing Address - Street 2:
Mailing Address - City:BOYD
Mailing Address - State:TX
Mailing Address - Zip Code:76023-6044
Mailing Address - Country:US
Mailing Address - Phone:580-772-7747
Mailing Address - Fax:
Practice Address - Street 1:519 E FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5337
Practice Address - Country:US
Practice Address - Phone:580-772-7747
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5735122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty