Martin, Kippy Glynn
Martin, Kippy Glynn is an individual health care provider with primary practice located at 100 S Bliss Ave , Tahlequah OK 74464-2512. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Martin, Kippy Glynn can be contacted via phone (918) 458-3100.Contact Information
Primary practice address
100 S Bliss Ave
Tahlequah OK 74464-2512
Phone: (918) 458-3100
Fax: (918) 458-3628
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 75052 | Oklahoma |
Profile Details
| NPI number | 1508929092 |
|---|---|
| LBN Legal business name | Martin, Kippy Glynn |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 18th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508929092 | NPPES |
| Oklahoma | MEDICAID | 1305052 |
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