Individual
STEVEN LEE GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1139 E KENOSHA ST, BROKEN ARROW, OK 74012-2006
(918) 259-0239
Mailing address
1139 E KENOSHA ST, BROKEN ARROW, OK 74012-2006
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5226
OK
Other
Enumeration date
10/16/2006
Last updated
07/08/2007
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