| NPI | 1063694883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENE RODGERS Office Manager 405-282-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5980) |
| Enumeration Date | 2007-12-04 |
| Last Update Date | 2007-12-04 |