| NPI | 1528027091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN V. NOWLIN Owner 918-492-6464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OK 5553) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-08-22 |