| NPI | 1063954642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADEN HOFMAN STOLTENBERG Dentist/CEO 405-406-1529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 6118) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |