Organization
MICHAEL A. KINCAID, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL A KINCAID D.D.S. (OWNER)
(918) 258-8515
Entity
Organization
Contact information
Practice address
1402 S ASPEN AVE, BROKEN ARROW, OK 74012-4807
(918) 258-8515
(918) 251-5463
Mailing address
1402 S ASPEN AVE, BROKEN ARROW, OK 74012-4807
(918) 258-8515
(918) 251-5463
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4037
OK
Other
Enumeration date
04/22/2008
Last updated
04/22/2008
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