| NPI | 1972764470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE NICOLE ST.CYR Office Manager 405-840-7714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 5067) |
| Enumeration Date | 2008-06-18 |
| Last Update Date | 2008-06-18 |