| NPI | 1487875258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL MULLASSERIL Director Of Maxillofacial Pros 405-271-5744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OK 5360) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2008-08-29 |