# JERRY L. THORMAN, DDS, INC.

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

## Provider details

- **NPI number:** 1851566731
- **Authorized official:** DR. JERRY L. THORMAN DDS (PRESIDENT)
- **Authorized official phone:** (918) 756-4933

## Contact information

- **Practice address:** 500 E 8TH ST, OKMULGEE, OK 74447-5503
- **Practice address phone:** (918) 756-4933
- **Practice address fax:** (918) 756-7781
- **Mailing address:** 500 E 8TH ST, OKMULGEE, OK 74447-5503
- **Mailing address phone:** (918) 756-4933
- **Mailing address fax:** (918) 756-7781

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | 3202 | OK | Yes |

## Other

- **Enumeration date:** 04/23/2008
- **Last updated:** 04/23/2008