SearchOklahomaGeneral Practice Dentistry

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