Individual
DR. GREGORY S SHANBOUR
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
8117 S WALKER AVE, OKLAHOMA CITY, OK 73139-9476
(405) 634-2239
(405) 634-3598
Mailing address
8117 S WALKER AVE, OKLAHOMA CITY, OK 73139-9476
(405) 634-2239
(405) 634-3598
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
4585
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4585
STATE DENTAL LICENSE
OK
Enumeration date
08/11/2005
Last updated
07/08/2007
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