| NPI | 1497497945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA BRASHER President 405-474-6362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2022-12-19 |