Organization
GRAND DENTAL EL RENO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL K KIRK DDS (MEMBER)
(405) 245-4828
Entity
Organization
Contact information
Practice address
1320 W ELM ST, EL RENO, OK 73036-4931
(405) 262-6737
(405) 262-6738
Mailing address
1320 W ELM ST, EL RENO, OK 73036-4931
(405) 262-6737
(405) 262-6738
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5116
OK
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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