Organization
FORT GIBSON FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOHN NELSON DDS (OWNER)
(918) 478-4433
Entity
Organization
Contact information
Practice address
801 S LEE ST, SUITE A, FORT GIBSON, OK 74434-8710
(918) 478-4433
(918) 478-4066
Mailing address
801 S LEE ST., SUITE A, FORT GIBSON, OK 74434
(918) 478-4433
(918) 478-4066
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/22/2007
Last updated
08/22/2020
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