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Individual

DR. WIRAWUT THOTHONG SEMTNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
404 S ELM ST STE 108, JENKS, OK 74037-3714
(918) 417-2417
Mailing address
404 S ELM ST STE 108, JENKS, OK 74037-3714
(918) 417-2417

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
7688
OK
122300000X
Dentist
DN26105
FL
1223P0221X
Pediatric Dentistry
Primary
141
OK

Other

Enumeration date
02/16/2021
Last updated
03/14/2024
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