| NPI | 1083740047 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA L SMITH CEO 918-483-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 122300000X Dentist |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2021-07-06 |