| NPI | 1730321407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENA KAYE STEWART Owner/Dentist 405-629-0020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: OK 5057) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2009-03-27 |
| Last Update Date | 2021-02-26 |