| NPI | 1043401599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD SCOTT WYATT President 405-373-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 4778) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2009-04-07 |