| NPI | 1962818351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN ALLAN ASHMORE Owner / President 405-949-0123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2014-07-07 |
| Last Update Date | 2014-07-07 |