| NPI | 1669648721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT B. DIETERLEN Owner/Dentist 918-299-2400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: OK 5167) |
| Enumeration Date | 2008-05-07 |
| Last Update Date | 2008-05-07 |