Grand Dental El Reno, Pllc

NPI #1205131141 in El Reno, Oklahoma

Provider Information

NPI Number: 1205131141
Entity Type: Organization
Organization Name: Grand Dental El Reno, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 25, 2011
Last Updated: Jan 25, 2011

Practice Location

Address: 1320 W ELM ST
City: El Reno
State: Oklahoma
ZIP Code: 73036-4931
Phone: (405) 262-6737

Authorized Official

Name: DR. MICHAEL K KIRK, DDS
Title: MEMBER
Phone: (405) 245-4828

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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