NPI | 1134387160 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN J FONDER Owner President 918-747-8802 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4514) |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2008-05-27 |
Last Update Date | 2008-05-27 |