Individual provider · Type 1 NPI

Gary E. Theobald, DMD

General Practice Dentistry · Broken Arrow, OK

NPI number 1467597104 Active

Practice location

2619 S Elm Pl
Broken Arrow, OK 74012-7878

Call (918) 455-0811 Map

Fax (918) 451-4787

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X3804 (OK)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1467597104

Gary E. Theobald, DMD's National Provider Identifier is 1467597104, issued on Feb 20, 2007. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Broken Arrow, OK. The record was last updated on Jul 8, 2007.