| NPI | 1932458312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOREN CHASE MICHAELSEN Dentist 918-266-6470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 6403) |
| Enumeration Date | 2012-08-31 |
| Last Update Date | 2012-08-31 |