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General NPI Number Information
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NPI Number | 1306374467
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Entity Type | Individual
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Provider Name | KIMBERLY KAY MERRITT DDS
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Gender | Female
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Dates
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Enumeration Date | 06/01/2017
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Last Update Date | 06/01/2017
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Provider Practice Location Address
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Address Line | 1226 W BROADWAY ST
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City | DRUMRIGHT
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State | OK
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Zip | 74030-5826
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Country | US
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Telephone | 918-844-4625
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Fax |
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Provider Business Mailing Address
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Address Line | 281 N SUNSET AVE
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City | SAND SPRINGS
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State | OK
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Zip | 74063-7363
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Country | US
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Telephone | 405-315-7759
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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 | 6945
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License Number State | OK
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