| NPI | 1215118096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAD MATTHEW GARRISON Dentist 918-443-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5278) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2007-11-20 |