| NPI | 1104053339 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE BELKNAP Dentist/Owner 405-329-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 4827) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 5911) |
| 122300000X Dentist (Licence: OK 5277) | |
| Enumeration Date | 2009-06-15 |
| Last Update Date | 2012-07-26 |