Theobald, Gary E
Theobald, Gary E is an sole proprietor health care provider with primary practice located at 2619 S Elm Pl , Broken Arrow OK 74012-7878. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Theobald, Gary E can be contacted via phone (918) 455-0811.Contact Information
Primary practice address
2619 S Elm Pl
Broken Arrow OK 74012-7878
Phone: (918) 455-0811
Fax: (918) 451-4787
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3804 | Oklahoma |
Profile Details
| NPI number | 1467597104 |
|---|---|
| LBN Legal business name | Theobald, Gary E |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 20th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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