Individual
DR. TERRY ROBERT ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
58 ST ANDREWS CIR, BROKEN ARROW, OK 74011-1107
(918) 252-0878
Mailing address
58 ST ANDREWS CIR, BROKEN ARROW, OK 74011-1107
(918) 252-0878
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
3131
OK
Other
Enumeration date
05/25/2010
Last updated
05/25/2010
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