| 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 |