| NPI | 1780105122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN JAMES BOWMAN Manager 405-326-8004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: OK 6076) |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2023-12-04 |