| NPI | 1609042910 |
|---|---|
| Doing Business As | SHADYBROOK COSMETIC & FAMILY DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TANYA L RODGERS Office Manager 405-737-3441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 5183) |
| Enumeration Date | 2008-05-06 |
| Last Update Date | 2008-05-06 |