| NPI | 1659545671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSTY WADE SULLINS Owner/Pres. 405-751-9222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5243) |
| Enumeration Date | 2008-04-22 |
| Last Update Date | 2008-04-22 |