| NPI | 1699940064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES S NICHOLSON Owner/ President 918-682-6452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 3655) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2008-04-28 |