| NPI | 1326054156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMER JOSIAH VAUGHT President 918-748-8868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: OK 4072) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-08-22 |