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General NPI Number Information
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NPI Number | 1023520087
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Entity Type | Individual
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Provider Name | ROSHAN NARESH KALRA DMD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2017
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Last Update Date | 10/31/2017
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Provider Practice Location Address
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Address Line | 7100 SE 15TH ST
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City | MIDWEST CITY
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State | OK
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Zip | 73110-5234
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Country | US
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Telephone | 405-241-9960
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Fax |
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Provider Business Mailing Address
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Address Line | 1325 N WALKER AVE APT 110
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City | OKLAHOMA CITY
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State | OK
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Zip | 73103-6408
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Country | US
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Telephone | 813-500-1541
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN22882
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 6990
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License Number State | OK
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