| NPI | 1083832133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAN L. NOWLIN Orthodontist 918-492-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OK 3601, SPECIALTY- 74) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |