Individual
NIPUN KOTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
500 SW 44TH ST, OKLAHOMA CITY, OK 73109-3540
(405) 632-6688
Mailing address
3000 N GRAND BLVD, OKLAHOMA CITY, OK 73107-1818
(405) 632-6688
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6551
OK
Other
Enumeration date
08/25/2009
Last updated
05/06/2024
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