| NPI | 1912172743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L DEVAUGHN President/Owner 580-233-2044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 3153) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |