| NPI | 1518479872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HODGSON Dentist/Owner 918-682-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OK 6821) |
| Enumeration Date | 2017-10-26 |
| Last Update Date | 2017-10-26 |