| NPI | 1790340743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA SEKIO HOPPER Owner/President/Manager 918-299-2182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-05-06 |
| Last Update Date | 2019-05-06 |