Organization
SPIRO FAMILY DENTAL P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEIFER LAYNE FISHER D. D. S. (PRESIDENT)
(918) 962-2466
Entity
Organization
Contact information
Practice address
318 W BROADWAY ST, SPIRO, OK 74959-2422
(918) 962-2466
(918) 962-4004
Mailing address
318 W BROADWAY ST, SPIRO, OK 74959-2422
(918) 962-2466
(918) 962-4004
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
4826
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200389460 A
—
OK
Enumeration date
10/11/2006
Last updated
01/09/2015
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