| Talihina Family Dentistry | |
|
200 Dallas St Talihina OK 74571-2402 | |
| (918) 567-3961 | |
| (918) 567-3424 |
| Full Name | Talihina Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 Dallas St, Talihina, Oklahoma |
| Authorized Official Name and Position | Kyle W Mcnatt (PRESIDENT) |
| Authorized Official Contact | 9185673961 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Talihina Family Dentistry Po Box 695 Talihina OK 74571-0695 Ph: (918) 230-8105 | Talihina Family Dentistry 200 Dallas St Talihina OK 74571-2402 Ph: (918) 567-3961 |
| NPI Number | 1598969487 |
|---|---|
| Provider Enumeration Date | 06/13/2007 |
| Last Update Date | 09/30/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598969487 | NPI | - | NPPES |
| 100736120A | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
R L Lake Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 Dallas St, Talihina, OK 74571 Phone: 918-567-3961 Fax: 918-567-3424 |