Healthcare Provider Details

I. General information

NPI: 1407056583
Provider Name (Legal Business Name): THOMAS H. GILBERT DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2007
Last Update Date: 07/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7116 S MINGO RD STE 112
TULSA OK
74133-3268
US

IV. Provider business mailing address

7116 S MINGO RD STE 112
TULSA OK
74133-3268
US

V. Phone/Fax

Practice location:
  • Phone: 918-250-5030
  • Fax: 918-254-8977
Mailing address:
  • Phone: 918-250-5030
  • Fax: 918-254-8977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number3221
License Number StateOK

VIII. Authorized Official

Name: DR. THOMAS GILBERT
Title or Position: DENTIST
Credential: DDS
Phone: 918-250-5030