| NPI | 1396931697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN CLARK VILLINES Dentist 580-772-2435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 5446) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2007-09-20 |