Individual
DEREK RAY COHLMIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4301 NW 63RD ST STE 303, OKLAHOMA CITY, OK 73116-1504
(405) 848-2886
Mailing address
4301 NW 63RD ST STE 303, OKLAHOMA CITY, OK 73116-1504
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6933
OK
Other
Enumeration date
06/14/2017
Last updated
06/14/2017
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