| NPI | 1457902595 |
|---|---|
| Doing Business As | BELLEVUE MODERN DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | MICHAEL ORNELAS Owner 405-504-6218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2023-12-26 |