Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Southeast Oklahoma Oral & Maxillofacial Surgery, PC

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1306839246

Southeast Oklahoma Oral & Maxillofacial Surgery, PC is an Oral and Maxillofacial Surgery (Dentist) in Ada, Oklahoma. Registered with an NPI since 2005.

In the registry since
2005
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

803 N Monte Vista St
Ada, OK 74820-7711
Phone: (580) 332-3010
Fax: (580) 332-3010
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1306839246
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official R. Boone — Oral Surgeon And Owner · (580) 332-3010
NPI enumeratedAugust 25, 2005
Last updated in NPPESMay 6, 2014
Mailing address803 N Monte Vista St, Ada, OK 74820-7711

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