NPI | 1831587575 |
---|---|
Entity Type | Organization |
Authorized Contact | ASHLEY DUSSAULT Office Manager 405-513-6630 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: OK OK4913) |
Additional Taxonomies | 122300000X Dentist (Licence: OK Ok6256) |
Enumeration Date | 2015-01-05 |
Last Update Date | 2015-01-07 |