| 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 |