NPI | 1245434166 |
---|---|
Entity Type | Organization |
Authorized Contact | BETH GRANT Office Manager 405-737-5123 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 3723) |
Enumeration Date | 2007-06-13 |
Last Update Date | 2021-06-25 |