| NPI | 1750793261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN A JOHNSON Managing Partner 918-260-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6592) |
| Enumeration Date | 2014-06-02 |
| Last Update Date | 2014-06-02 |