| NPI | 1972761427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY NEILL BLACK Owner/Dentist 918-745-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5573) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2018-05-10 |