| NPI | 1174607261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BRIAN SHADID Partner 405-843-9330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OK 458428) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: OK 512734) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |