| NPI | 1023239449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN CHRIS CLARK Chairman Of The Board 405-681-6668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK OK4100) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-09-12 |