| NPI | 1366775140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R KEITHLINE Managing Member 918-585-3744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5859) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2009-09-11 |