Provider Demographics
NPI:1548277114
Name:TODD, DEAN O (DDS)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:O
Last Name:TODD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7134 S. YALE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136
Mailing Address - Country:US
Mailing Address - Phone:918-439-2444
Mailing Address - Fax:918-477-7692
Practice Address - Street 1:7134 S. YALE
Practice Address - Street 2:SUITE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136
Practice Address - Country:US
Practice Address - Phone:918-439-2444
Practice Address - Fax:918-477-7692
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK4665122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist