| NPI | 1639528334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTA SELLERS Prosthodontist 701-400-7283 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: ND 2181) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2016-06-03 |