| NPI | 1710010285 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN DALE CLOTHIER Owner 918-251-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 5817) |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2020-08-22 |