Provider Demographics
NPI:1750729398
Name:GARRETT, JOHN ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALAN
Last Name:GARRETT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 N TACOMA AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74127-6717
Mailing Address - Country:US
Mailing Address - Phone:918-605-5114
Mailing Address - Fax:
Practice Address - Street 1:1646 E 6TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-4001
Practice Address - Country:US
Practice Address - Phone:918-895-6933
Practice Address - Fax:918-576-6887
Is Sole Proprietor?:No
Enumeration Date:2013-06-05
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6482122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist