| NPI | 1003083593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL ERIC COATNEY President/Owner 918-299-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 4686) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |