Gary E Theobald, DMD

NPI #1467597104 in Broken Arrow, Oklahoma

Provider Information

NPI Number
1467597104
Entity Type
Individual
Name
Gary E Theobald, DMD
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - General Practice
Credential
DMD
Enumeration Date
Feb 20, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
2619 S ELM PL
ZIP Code
74012-7878
Phone
(918) 455-0811

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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