| NPI | 1164831384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN BOWMAN Manager 405-326-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6076) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2020-11-09 |