Casey Dillon Osterhout, DMD

Individual provider Active NPI General Practice Dentistry · Wilburton, OK

NPI 1073676862 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1073676862
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5805 (OK)
Practice address
114 W Main St
Wilburton, OK 74578-4044
Phone
(918) 465-3535
NPI assigned
Dec 19, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Broadway Dental, LLC General Practice Past Accepting new patients
Mobile Dental Services, LLC General Practice Past Accepting new patients
Wilburton Family Dentistry, LLC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5805 OK Yes

Addresses

Primary practice location

114 W Main St
Wilburton, OK 74578-4044

Mailing address

615 E 17TH St
Stroud, OK 74079-5316
Phone (918) 706-5584

Other providers in Wilburton, OK

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

Sources for this page

Verify at the official NPI Registry.