Healthcare Provider Details

I. General information

NPI: 1821370578
Provider Name (Legal Business Name): ROB PATRICK GEUNES DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2011
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5314 NW CACHE RD
LAWTON OK
73505-3313
US

IV. Provider business mailing address

5314 NW CACHE RD
LAWTON OK
73505-3313
US

V. Phone/Fax

Practice location:
  • Phone: 580-595-9620
  • Fax: 580-595-9965
Mailing address:
  • Phone: 580-595-9620
  • Fax: 580-595-9965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number6323
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: