| NPI | 1770824781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARC L SUSMAN Owner / Doctor 918-683-8844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4774) |
| Enumeration Date | 2013-03-15 |
| Last Update Date | 2013-03-15 |