Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | DD3972 | NM |
N | 213EG0000X | General Practice | DD3972 | NM |
Y | 1223P0221X | Pediatric Dentist | DD3972 | NM |
NPI | 1104252709 |
---|---|
Provider Name | Dr. Kami Lynn Groten |
First Address | Lawton, OK 73507-3099 |
Second Address | Lawton, OK 73507-3099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/09/2013 |
Last Update Date | 26/06/2020 |