| NPI | 1619291762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA E SAMS Contract Coordinator 918-494-8634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 3818) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-03-18 |