Individual
MR. CHARLES RAYMOND KONDO GROTHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
401 E RANDOLPH, ENID, OK 73701
(580) 233-4561
(580) 233-4561
Mailing address
401 E RANDOLPH, ENID, OK 73701
(580) 233-4561
(580) 233-4561
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4600
OK
Other
Enumeration date
08/16/2006
Last updated
07/08/2007
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