Individual
DR. GRADY LABAR LEMBKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
200 N SOONER RD BLDG B, EDMOND, OK 73034-7153
(405) 330-6020
(405) 341-0557
Mailing address
200 N SOONER RD BLDG B, EDMOND, OK 73034-7153
(405) 330-6020
(405) 341-0557
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5432
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#5432
OKLAHOMA LICENSE #
OK
01
—
875019
UNITED CONCORDIA
—
Enumeration date
08/18/2006
Last updated
04/06/2011
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