Provider Demographics
NPI:1811991375
Name:BARTLETT, BOBBIE K (DDS)
Entity type:Individual
Prefix:DR
First Name:BOBBIE
Middle Name:K
Last Name:BARTLETT
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 1:28243 S LOVERS LN
Mailing Address - Street 2:
Mailing Address - City:PARK HILL
Mailing Address - State:OK
Mailing Address - Zip Code:74451-2939
Mailing Address - Country:US
Mailing Address - Phone:405-641-4544
Mailing Address - Fax:
Practice Address - Street 1:6521 S WESTERN AVE
Practice Address - Street 2:STE A
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-1705
Practice Address - Country:US
Practice Address - Phone:405-634-2313
Practice Address - Fax:405-634-0474
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-11
Last Update Date:2014-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5101122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
73-1435469OtherTAX ID