| NPI | 1699025122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE NOLAN WYATT Orthodontist 918-496-1155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OK 5561) |
| Enumeration Date | 2012-09-12 |
| Last Update Date | 2020-08-05 |