Individual
ROAH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2036 S MILLER LN STE B, CATOOSA, OK 74015-1539
(918) 937-7660
Mailing address
16204 S 89TH EAST AVE, BIXBY, OK 74008-4493
(801) 884-2460
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8066
OK
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
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