| NPI | 1891177937 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY R DEWBRE Gra 405-271-4148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: OK 6640) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |