| NPI | 1629110119 |
|---|---|
| Former Legal Business Name | UNIVERSITY DENTAL FACULTY GROUP |
| Entity Type | Organization |
| Authorized Contact | D. MICHELLE PARK Director 405-271-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2014-01-06 |