| NPI | 1649416876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE LYNN SOUTHARD President/Endodontist 918-493-3880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: OK 5119) |
| Enumeration Date | 2008-12-17 |
| Last Update Date | 2008-12-17 |