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General NPI Number Information
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NPI Number | 1285636027
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Entity Type | Individual
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Provider Name | RONALD K. GIRLINGHOUSE D.D.S, P.A.
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Gender | Male
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Dates
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Enumeration Date | 08/11/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1206 BROWN BLVD
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City | SALLISAW
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State | OK
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Zip | 74955-7263
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Country | US
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Telephone | 918-775-5775
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Fax |
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Provider Business Mailing Address
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Address Line | 3109 HEATHER OAKS WAY
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City | FORT SMITH
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State | AR
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Zip | 72908-9313
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Country | US
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Telephone | 918-775-5775
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 5312
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License Number State | OK
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