| NPI | 1588725485 |
|---|---|
| Doing Business As | FAIRFAX DENTAL OFFICE |
| Entity Type | Organization |
| Authorized Contact | KELLY LYNETTE HADLOCK Office Manager 918-642-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2015-02-13 |