Individual
DR. KYLE ROBERT MICHELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2750 NW 23RD ST, OKLAHOMA CITY, OK 73107-2212
(405) 942-4445
Mailing address
8305 NW 86TH ST, OKLAHOMA CITY, OK 73132-3234
(405) 697-8695
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
T-7317
OK
Other
Enumeration date
06/08/2020
Last updated
06/08/2020
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