Provider Demographics
NPI:1912065574
Name:COZORT-STOKES, KIMBERLY HILL (DDS)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:HILL
Last Name:COZORT-STOKES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KIMBERLY
Other - Middle Name:ANN
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5639 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-6010
Mailing Address - Country:US
Mailing Address - Phone:918-622-3353
Mailing Address - Fax:918-622-5996
Practice Address - Street 1:5639 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-6010
Practice Address - Country:US
Practice Address - Phone:918-622-3353
Practice Address - Fax:918-622-5996
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK54211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice