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Gary Theobald, DMD
NPI 1467597104 · on the registry since 2007 · sole proprietor
Practice
- Address
- 2619 S Elm Pl
Broken Arrow, OK 74012 - Phone
- (918) 455-0811
- Fax
- (918) 451-4787
- Organisation at this address
- Reusser And Reusser Llc
Advantage Dental Oral Health Center Of Oklahoma, P.C.Inferred from a shared address, not stated in the registry. - Clinicians at this address
- 5
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma