| NPI | 1902276025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CALLIE D BOUZIDEN Dentist/Owner 405-376-3320 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6183) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2020-11-09 |