Individual
THEODORE NICHOLAS KONDOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2208 N BROADWAY #104, POTEAU, OK 74953-0933
(918) 647-8266
(918) 647-9118
Mailing address
PO BOX 933, 2208 N BROADWAY #104, POTEAU, OK 74953-0933
(918) 647-8266
(918) 647-9118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4254
OK
Other
Enumeration date
11/16/2006
Last updated
07/08/2007
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