| NPI | 1730474800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON M LINDBLOM Owner 918-331-0016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 6092) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2022-10-18 |