| NPI | 1093383952 |
|---|---|
| Doing Business As | NORTHEAST DENTAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | WILLIAM A CLARK Owner 405-427-5405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2021-06-16 |