Organization
DENTAL LODGE AT BROOKHAVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY D NABORS JR. D.D.S. (OWNER)
(405) 872-9597
Entity
Organization
Contact information
Practice address
3700 W ROBINSON ST, SUITE 102, NORMAN, OK 73072-3659
(405) 872-9597
Mailing address
PO BOX 69, NOBLE, OK 73068-0069
(405) 872-9597
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5955
OK
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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