Altus Mangum Dental PLLC

Organization Active NPI General Practice Dentistry · Altus, OK

NPI 1043816671 · NPPES record last updated Dec 9, 2020

Key facts

NPI
1043816671
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
ALTUS MANGUM DENTAL PLLC
Practice address
907 Falcon Rd
Altus, OK 73521-2833
Phone
(580) 482-3974
Fax
(580) 482-0800
NPI assigned
Dec 9, 2020
Organization subpart
Yes
Parent organization (as reported)
ALTUS MANGUM DENTAL PLLC

Authorized official

Name
Nathan Sethman, DDS
Title
General Dentist
Phone
(580) 482-3974

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Altus Mangum Dental PLLC (2 organizations share this tax ID)
Part of
Altus Mangum Dental PLLC

Locations

907 Falcon Rd
Altus, OK 73521
Phone (580) 482-3974

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X Yes

Addresses

Primary practice location

907 Falcon Rd
Altus, OK 73521-2833

Mailing address

1410 1/2 N Louis Tittle Ave
Mangum, OK 73554-2218
Phone (580) 782-5513

Other identifiers

IdentifierTypeStateIssuer
1223G0001XOtherOKGENERAL DENTIST

Other names

  • AM Dental Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL desktop Health Information Exchange (HIE) Altus Mangum Dental PLLC

Other providers in Altus, OK

All providers in Altus, OK · General Practice Dentistry in Oklahoma

Sources for this page

Verify at the official NPI Registry.