WISDOM TOOTH CENTER PLLC NPI 1801303888

NPI Information

  • NPI: 1801303888
  • Provider Name: WISDOM TOOTH CENTER, PLLC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 2745 S I 35 SERVICE RD
    MOORE, OK
    ZIP 73160
  • Phone: (405) 271-4955

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NPI Details

WISDOM TOOTH CENTER, PLLC is an oral and maxillofacial surgery dentist in Moore, OK. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. WISDOM TOOTH CENTER, PLLC NPI is 1801303888. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2745 S I 35 SERVICE RD
MOORE, OK
ZIP 73160-715
Phone: (405) 271-4955

The provider's authorized official is Kevin S Smith .
The authorized official title is Partner and has the following contact phone number (405) 271-4955.

The enumeration date for this NPI number is 12/29/2017 and was last updated on 12/29/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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