| NPI | 1821244799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WADE MERIDETH President 405-640-4435 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5807) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2008-08-12 |