| NPI | 1144576539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN NICHOLAS PROUD Dr/Owner 405-282-2530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6152) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2012-08-03 |