| NPI | 1912221052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA E SAMS Contract Coordinator 918-449-5800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: OK 5019) |
| Enumeration Date | 2010-03-18 |
| Last Update Date | 2010-12-20 |