| NPI | 1275895344 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS VINSON Dentist 918-492-1917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OK 6062) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |