| NPI | 1336154756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES LEE ROSKAMP Pres/Owner 918-451-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 3861) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |