| NPI | 1215016498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY M WENTE Office Administrator 405-340-5110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4357) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2008-06-27 |