| NPI | 1609018548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES R KEITHLINE Managing Member 918-585-3744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 784) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |