Jack, Jerry
Jack, Jerry is an individual health care provider with primary practice located at 1740 N Service Rd , Moore OK 73160-3307. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jack, Jerry can be contacted via phone (405) 794-7200.Contact Information
Primary practice address
1740 N Service Rd
Moore OK 73160-3307
Phone: (405) 794-7200
Fax: (405) 794-2266
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 3903 | Oklahoma |
Profile Details
| NPI number | 1265463467 |
|---|---|
| LBN Legal business name | Jack, Jerry |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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