Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 196 | OK |
N | 1223X0400X | Orthodontists | 352 | OK |
NPI | 1013204601 |
---|---|
Provider Name | Dr. Alejandro Alberto Romero Delmastro |
First Address | Enid, OK 73703-4945 |
Second Address | Enid, OK 73703-4945 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2011 |
Last Update Date | 10/03/2019 |