Provider Demographics
NPI:1013034164
Name:R K GIRLINGHOUSE DDS PA
Entity Type:Organization
Organization Name:R K GIRLINGHOUSE DDS PA
Other - Org Name:DENTURE TODAY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CASSKE
Authorized Official - Middle Name:
Authorized Official - Last Name:JINKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:479-474-7600
Mailing Address - Street 1:1290 MENTZER AVE
Mailing Address - Street 2:
Mailing Address - City:SALLISAW
Mailing Address - State:OK
Mailing Address - Zip Code:74955-7282
Mailing Address - Country:US
Mailing Address - Phone:918-775-5775
Mailing Address - Fax:479-775-6777
Practice Address - Street 1:1290 MENTZER AVE
Practice Address - Street 2:
Practice Address - City:SALLISAW
Practice Address - State:OK
Practice Address - Zip Code:74955-7282
Practice Address - Country:US
Practice Address - Phone:918-775-5775
Practice Address - Fax:479-775-6777
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2023-03-10
Deactivation Date:2008-06-03
Deactivation Code:
Reactivation Date:2008-07-23
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty