| NPI | 1063698397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES CLINTON OWENS President 580-248-6062 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 3479) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |