| NPI | 1588805295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JAMES WALLS President 405-485-6080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OK 5630) |
| Enumeration Date | 2009-03-11 |
| Last Update Date | 2009-03-11 |