# ADOLPH FAMILY DENTISTRY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164535183
- **Authorized official:** DR. GARY PHILLIP ADOLPH DDS (DOCTOR DENTAL SURGERY)
- **Authorized official phone:** (918) 756-0270

## Contact information

- **Practice address:** 112 N GRAND, OKMULGEE, OK 74447
- **Practice address phone:** (918) 756-0270
- **Practice address fax:** (918) 756-0283
- **Mailing address:** 112 N GRAND, OKMULGEE, OK 74447
- **Mailing address phone:** (918) 756-0270
- **Mailing address fax:** (918) 756-0283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4862 | OK | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 08/22/2020