Individual
RON GENE WALKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
311 S RENNIE ST, ADA, OK 74820-6536
(580) 332-1010
Mailing address
311 S RENNIE ST, ADA, OK 74820-6536
(580) 332-1010
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5397
OK
Other
Enumeration date
08/11/2006
Last updated
07/09/2007
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