| NPI | 1720514805 |
|---|---|
| Doing Business As | KIDS DENTAL |
| Entity Type | Organization |
| Authorized Contact | SEAN COSTELLO Owner/Dentist 918-895-8090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 5475) |
| Enumeration Date | 2017-05-10 |
| Last Update Date | 2017-05-10 |