| NPI | 1790907343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY WALLACE FISHER Owner 918-744-1555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 4229) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |