Individual
DR. TIMOTHY EZEAL KINNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
701 NE 36TH ST, OKLAHOMA CITY, OK 73105-7203
(405) 524-7214
(405) 524-7217
Mailing address
PO BOX 54918, OKLAHOMA CITY, OK 73154-1918
(405) 524-7214
(405) 524-7217
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5485
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12
DENTAL PRACTICE
OK
Enumeration date
01/05/2007
Last updated
07/08/2007
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