| NPI | 1376722314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN SOUTHARD Office Manager 918-294-1144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5455) |
| Enumeration Date | 2007-10-26 |
| Last Update Date | 2007-10-26 |