Provider Demographics
NPI:1205976057
Name:OCEAN DENTAL, PC
Entity type:Organization
Organization Name:OCEAN DENTAL, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
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 1:913 W MAPLE AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-3869
Practice Address - Country:US
Practice Address - Phone:580-242-3033
Practice Address - Fax:580-242-1217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty