| NPI | 1306012158 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK TANNER HANSTEIN Owner 405-235-7288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4693) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |