| NPI | 1538867411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT RANDAL WARN Dentist 580-248-4224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 122300000X Dentist |
| 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment | |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2025-05-15 |