| NPI | 1508905068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | W. SCOTT WAUGH General Denstist 405-341-6134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 3653) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |