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Organization

KELLY KLONTZ DDS,PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KELLY JAMES KLONTZ DDS (OWNER)
(405) 691-8100
Entity
Organization

Contact information

Practice address
9721 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-6900
(405) 691-8100
Mailing address
9721 S PENNSYLVANIA AVE, OKLAHOMA CITY, OK 73159-6900
(405) 691-8100

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4878
OK

Other

Enumeration date
07/15/2015
Last updated
07/15/2015
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