Provider First Line Business Practice Location Address:
1201 N STONEWALL AVE.
Provider Second Line Business Practice Location Address:
OUHSC COLLEGE OF DENTISTRY
Provider Business Practice Location Address City Name:
OKLAHOMA CITY
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
73117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
405-271-5735
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2007