| NPI | 1003290545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY JAMES KLONTZ Owner 405-691-8100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OK 4878) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2015-07-15 |