| NPI | 1548565070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY STARK HENDERSON Dentist 918-762-3501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 3796) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |