| NPI | 1205319795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY CARTER Manager/Member 918-688-3399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2018-09-11 |