| NPI | 1720165616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY MADDOX Owner/President 918-369-1202 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4417) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-07-24 |