Provider Demographics
NPI:1649464843
Name:WINTERS, TEVI K (DDS)
Entity type:Individual
Prefix:DR
First Name:TEVI
Middle Name:K
Last Name:WINTERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 W AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-9603
Mailing Address - Country:US
Mailing Address - Phone:405-238-2222
Mailing Address - Fax:405-238-5181
Practice Address - Street 1:1600 W AIRLINE RD
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-9603
Practice Address - Country:US
Practice Address - Phone:405-238-2222
Practice Address - Fax:405-238-5181
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK59701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice