Provider Demographics
NPI:1396755476
Name:TINKER, TERRY W (DDS)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:W
Last Name:TINKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:TERRY
Other - Middle Name:W
Other - Last Name:TINKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS PC
Mailing Address - Street 1:6565 SO YALE
Mailing Address - Street 2:SUITE 603
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-492-3681
Mailing Address - Fax:918-492-3222
Practice Address - Street 1:6565 SO YALE
Practice Address - Street 2:SUITE 603
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-492-3681
Practice Address - Fax:918-492-3222
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK49421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice