| NPI | 1982870838 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY MARK HODGE President 918-250-9528 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: OK 4660) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: OK 4301) |
| 1223G0001X Dentist, General Practice (Licence: OK 4156) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |