Organization
KYLE L. SERFOSS, DDS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KYLE LANDON SERFOSS D.D.S (DENTIST)
(580) 323-0763
Entity
Organization
Contact information
Practice address
810 W GARY BLVD, CLINTON, OK 73601-2720
(580) 323-0763
(580) 323-5532
Mailing address
810 W GARY BLVD, CLINTON, OK 73601-2720
(580) 323-0763
(580) 323-5532
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5881
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200090120A
—
OK
Enumeration date
02/05/2008
Last updated
02/05/2008
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