| NPI | 1710175484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONAL R WOODWARD President 918-492-6994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: OK 4638) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2008-07-30 |