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Individual
DR. JEREMY LEWIS EGAN
Active
Individual
DR. JEREMY LEWIS EGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
7760
OK
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2024047374
MO
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
234
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
04/08/2017
Last updated
01/20/2025
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