Organization
KEYS FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY D SNELL II DDS (OWNER)
(918) 458-5140
Entity
Organization
Contact information
Practice address
26245 HIGHWAY 82, SUITE 2, PARK HILL, OK 74451-3802
(918) 458-5140
(918) 458-5155
Mailing address
26245 HIGHWAY 82, SUITE 2, PARK HILL, OK 74451-3802
(918) 458-5140
(918) 458-5155
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5496
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200039590A
—
OK
Enumeration date
10/09/2008
Last updated
10/09/2008
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