Shankle Dental-broken Arrow Pllc | |
2522 E Kenosha St Broken Arrow OK 74014-6712 | |
(191) 835-5139 | |
Not Available |
Full Name | Shankle Dental-broken Arrow Pllc |
---|---|
Speciality | Dentist - General Practice |
Location | 2522 E Kenosha St, Broken Arrow, Oklahoma |
Authorized Official Name and Position | Kenneth Shankle (OWNER) |
Authorized Official Contact | 9183551391 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Shankle Dental-broken Arrow Pllc 2522 E Kenosha St Broken Arrow OK 74014-6712 Ph: (191) 835-5139 | Shankle Dental-broken Arrow Pllc 2522 E Kenosha St Broken Arrow OK 74014-6712 Ph: (191) 835-5139 |
NPI Number | 1265902183 |
---|---|
Provider Enumeration Date | 12/04/2018 |
Last Update Date | 12/04/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1265902183 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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