| NPI | 1902073505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY A SCHROEDER Office Manager 918-492-3771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: OK 4087) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2008-05-13 |