| NPI | 1730350935 |
|---|---|
| Doing Business As | PERIODONTAL IMPLANT CENTER |
| Entity Type | Organization |
| Authorized Contact | JACOB DANIEL HAGER President 405-636-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 5718) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2008-03-14 |