| NPI | 1750688248 |
|---|---|
| Doing Business As | RIVERWALK DENTAL SPA |
| Entity Type | Organization |
| Authorized Contact | CARRIE D SESSOM Owner 918-392-7654 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: OK 5239) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2014-09-09 |