| NPI | 1720437296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY DEAN TATE Dentist 405-262-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 6815) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2021-07-12 |