| NPI | 1164697074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMALA CANTWELL Office Mgr 918-342-3477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4601) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |