| NPI | 1366568438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA M. WHITE Manager 405-616-7336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 4636) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |