| Spiro Family Dental P.c. | |
|
318 W Broadway St Spiro OK 74959-2422 | |
| (918) 962-2466 | |
| (918) 962-4004 |
| Full Name | Spiro Family Dental P.c. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 318 W Broadway St, Spiro, Oklahoma |
| Authorized Official Name and Position | Keifer Layne Fisher (PRESIDENT) |
| Authorized Official Contact | 9189622466 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Spiro Family Dental P.c. 318 W Broadway St Spiro OK 74959-2422 Ph: (918) 962-2466 | Spiro Family Dental P.c. 318 W Broadway St Spiro OK 74959-2422 Ph: (918) 962-2466 |
| NPI Number | 1730277740 |
|---|---|
| Provider Enumeration Date | 10/11/2006 |
| Last Update Date | 01/09/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730277740 | NPI | - | NPPES |
| 200389460 A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 4826 (Oklahoma) | Primary |