Fort Gibson Family Dentistry PC
NPI #1114052032 in Fort Gibson, Oklahoma
Provider Information
- NPI Number
- 1114052032
- Entity Type
- Organization
- Organization Name
- Fort Gibson Family Dentistry PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Feb 22, 2007
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 801 S LEE ST
- Address 2
- SUITE A
- City
- Fort Gibson
- State
- Oklahoma
- ZIP Code
- 74434-8710
- Phone
- (918) 478-4433
Authorized Official
- Name
- DR. MICHAEL JOHN NELSON, DDS
- Title
- OWNER
- Phone
- (918) 478-4433
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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