NPI | 1265735724 |
---|---|
Entity Type | Organization |
Authorized Contact | VERA ANN WELLNER Credentialing Rep 405-848-7974 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 160) |
Enumeration Date | 2010-12-06 |
Last Update Date | 2013-11-13 |