| NPI | 1164276572 |
|---|---|
| Doing Business As | WISDOM TEETH OKC |
| Entity Type | Organization |
| Authorized Contact | CHARLOTTE DASCH Director Of Credentialing &Pr 504-638-0303 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2024-04-12 |
| Last Update Date | 2024-04-12 |