Grand River Dental | |
12 E. Commercial Inola OK 74036 | |
(918) 369-4300 | |
(918) 369-6440 |
Full Name | Grand River Dental |
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Speciality | Dentist - General Practice |
Location | 12 E. Commercial, Inola, Oklahoma |
Authorized Official Name and Position | S Scott Laster (DENTIST/ PRESIDENT) |
Authorized Official Contact | 9183694300 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Grand River Dental Po Box 99 Inola OK 74036-0099 Ph: (918) 369-4300 | Grand River Dental 12 E. Commercial Inola OK 74036 Ph: (918) 369-4300 |
NPI Number | 1265690192 |
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Provider Enumeration Date | 05/28/2008 |
Last Update Date | 05/28/2008 |
Identifier | Type | State | Issuer |
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1265690192 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 5021 (Oklahoma) | Primary |