| NPI | 1851485494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY WAYNE SMITH Owner 918-492-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: OK 3196) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |