Individual
CHARLES H MCINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8110 E 21ST ST, TULSA, OK 74129-1402
(918) 622-5700
(918) 622-4830
Mailing address
8110 E 21ST ST, TULSA, OK 74129-1402
(918) 622-5700
(918) 622-4830
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3598
OK
Other
Enumeration date
02/25/2008
Last updated
02/25/2008
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