Brant Rouse DDS PLC
Organization Active NPI Dentist · Tahlequah, OK
NPI 1003131459 · NPPES record last updated Aug 7, 2020
Key facts
- NPI
- 1003131459
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- Legal business name
- BRANT ROUSE DDS PLC
- Practice address
- 559 Meadow Creek Drive
Tahlequah, OK 74464-1088 - Phone
- (918) 456-0977
- Fax
- (855) 856-5958
- NPI assigned
- Mar 29, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Brant Philip Rouse, DDS
- Title
- President
- Phone
- (918) 456-0977
Practitioners 3
-
Brant Philip Rouse, D.D.S.
-
Thomas Craig Been, DDS
-
Justin Roberts, DDS
National Provider Directory
Locations
206 E Downing St
Tahlequah, OK 74464
Phone (539) 242-5742
559 Meadow Creek Dr
Tahlequah, OK 74464
Phone (918) 456-0977
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | Yes |
Addresses
Primary practice location
559 Meadow Creek Drive
Tahlequah, OK 74464-1088
Mailing address
559 Meadow Creek Drive
Tahlequah, OK 74464-1088
Phone (918) 456-0977
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200081330A | Medicaid | OK |
Other providers in Tahlequah, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 7, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.