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General NPI Number Information
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NPI Number | 1902395346
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Entity Type | Organization
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Legal Business Name | NORMAN DENTAL GROUP LLC
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Dates
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Enumeration Date | 05/01/2018
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Last Update Date | 05/01/2018
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Provider Practice Location Address
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Address Line | 2408 PALMER CIR
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City | NORMAN
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State | OK
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Zip | 73069-6301
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Country | US
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Telephone | 405-801-3147
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Fax | 888-975-7437
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Provider Business Mailing Address
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Address Line | 2408 PALMER CIR
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City | NORMAN
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State | OK
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Zip | 73069-6301
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Country | US
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Telephone | 405-801-3147
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Fax | 888-975-7437
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Authorized Official
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Title or Position | CO - OWNER
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Name | DR. DENAE MICAE KIRKPATRICK
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Credential | DDS
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Telephone | 405-209-7013
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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 | 5486
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License Number State | OK
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