Provider Demographics
NPI:1225605298
Name:BOCK, SALLY MARGARET X (DDS)
Entity type:Individual
Prefix:DR
First Name:SALLY
Middle Name:MARGARET
Last Name:BOCK
Suffix:X
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 PEACHTREE CT
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-2920
Mailing Address - Country:US
Mailing Address - Phone:405-821-0284
Mailing Address - Fax:
Practice Address - Street 1:2619 S ELM PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7878
Practice Address - Country:US
Practice Address - Phone:918-872-0218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-08
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK74131223G0001X
NY0645841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice