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Wrany R Southard, D.D.S., P.C.

Individual provider Active NPI General Practice Dentistry · Tulsa, OK

NPI 1780717702 · NPPES record last updated Oct 26, 2007

Key facts

NPI
1780717702
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5455 (OK)
Practice address
6333 S Memorial Dr Ste G
Tulsa, OK 74133-1947
Phone
(918) 294-1144
Fax
(918) 294-0884
NPI assigned
Mar 13, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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

State licenses

LicenseStateTypeSpecialty
5455OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wrany R. Southard, D.D.S., P.C. General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5455 OK Yes

Addresses

Primary practice location

6333 S Memorial Dr Ste G
Tulsa, OK 74133-1947

Mailing address

6333 S Memorial Dr Ste G
Tulsa, OK 74133-1947
Phone (918) 294-1144

Other providers in Tulsa, OK

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

Sources for this page

Verify at the official NPI Registry.