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NPI Code Detail

MEDICARE: DR. KIMBERLY D GREENLEE DDS

MEDICARE:  DR. KIMBERLY D GREENLEE  DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry5873OK

General Provider Information

NPI Number : 1669522009
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIMBERLY D GREENLEE DDS
Provider Business Mailing Address
First Line : MY DENTIST 1900 S. AIR DEPOT
Second Line : SUITE 1
City : MIDWEST CITY
State : OK
Zip : 73110-5522
Country : US
Telephone Number : 405-455-1534
Fax Number : 405-455-1513
Provider Business Practice Location Address
First Line : MY DENTIST 1900 S. AIR DEPOT
Second Line : SUITE 1
City : MIDWEST CITY
State : OK
Zip : 73110-5522
Country : US
Telephone Number : 405-455-1534
Fax Number : 405-455-1513
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 11/21/2007

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Directions to “ DR. KIMBERLY D GREENLEE DDS” Practice Location

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