| NPI | 1164535183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY PHILLIP ADOLPH Doctor Dental Surgery 918-756-0270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 4862) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |