Provider Demographics
NPI:1518060102
Name:LOCKARD, JOHN T (DDS MS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:LOCKARD
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Gender:M
Credentials:DDS MS
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Mailing Address - Street 1:3200 SOUTH ELM PLACE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7908
Mailing Address - Country:US
Mailing Address - Phone:918-455-0976
Mailing Address - Fax:918-455-0576
Practice Address - Street 1:3200 SOUTH ELM PLACE
Practice Address - Street 2:SUITE 110
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7908
Practice Address - Country:US
Practice Address - Phone:918-455-0976
Practice Address - Fax:918-455-0576
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK37611223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics