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Organization
DR THEODORE W KONDOS DDS PC
Active
Organization
DR THEODORE W KONDOS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THEODORE NICHOLAS KONDOS DDS (CEO DDS)
(918) 647-8266
Entity
Organization
Contact information
Practice address
2208 NO BROADWAY, POTEAU, OK 74953
(918) 647-8266
(918) 647-9118
Mailing address
PO BOX 933, POTEAU, OK 74953
(918) 647-8266
(918) 647-9118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
973697
UNITED CONCORDIA
—
Enumeration date
05/21/2008
Last updated
05/21/2008
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