Provider Demographics
NPI:1174680896
Name:TONY STRETESKY DDS
Entity type:Organization
Organization Name:TONY STRETESKY DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:TONY
Authorized Official - Middle Name:
Authorized Official - Last Name:STRETESKY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:580-226-2331
Mailing Address - Street 1:1119 WALNUT DRIVE
Mailing Address - Street 2:SUITE 4
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401
Mailing Address - Country:US
Mailing Address - Phone:580-226-2331
Mailing Address - Fax:580-226-8776
Practice Address - Street 1:1119 WALNUT DRIVE
Practice Address - Street 2:SUITE 4
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401
Practice Address - Country:US
Practice Address - Phone:580-226-2331
Practice Address - Fax:580-226-8776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK39071223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty