| NPI | 1497205660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN ALLEN LANDERS Owner 918-249-0249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 5353) |
| Additional Taxonomies | 122300000X Dentist (Licence: OK 5326) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 3842) | |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 5364) | |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2016-10-11 |