| NPI | 1205935368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI TRIEBEL SMITH Owner President Dentist 918-825-7645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5334) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2008-04-24 |