| NPI | 1427519669 |
|---|---|
| Doing Business As | WALTON BLVD. DENTAL |
| Entity Type | Organization |
| Authorized Contact | RENEE MCBAY Credentialing Manager 918-998-0996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2020-02-18 |