# JERRY L GREER DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376725051
- **Authorized official:** JERRY L GREER DDS (SURGEON)
- **Authorized official phone:** (918) 747-4760

## Contact information

- **Practice address:** 2105 E 21ST ST, TULSA, OK 74114-1409
- **Practice address phone:** (918) 747-4760
- **Practice address fax:** (918) 747-6731
- **Mailing address:** 2105 E 21ST ST, TULSA, OK 74114-1409
- **Mailing address phone:** (918) 747-4760
- **Mailing address fax:** (918) 747-6731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 3693 | OK | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 5797 | OK | — |

## Other

- **Enumeration date:** 12/04/2007
- **Last updated:** 06/08/2009