| NPI | 1013416940 |
|---|---|
| Doing Business As | SHEPHERD MALL FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MARK JAY ALLEN Partneer 405-844-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OK 4333) |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2018-06-16 |