NPI | 1871767889 |
---|---|
Entity Type | Organization |
Authorized Contact | CLINTON DRAKE STEVENS President 918-587-1303 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5979) |
Enumeration Date | 2008-04-22 |
Last Update Date | 2008-04-22 |