Individual
DR. KATHLEEN SUE CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
315 S UTICA AVE, TULSA, OK 74104-2203
(918) 594-4860
(918) 594-4889
Mailing address
14736 S LEWIS AVE, BIXBY, OK 74008-3626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4593
OK
Other
Enumeration date
11/13/2006
Last updated
07/08/2007
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