| NPI | 1467574004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM R FARMER Owner 918-521-0473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5609) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 2933) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 5590) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2019-10-11 |