Individual
JILLIAN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
801 S LEE ST STE A, FORT GIBSON, OK 74434-8710
(918) 478-4433
Mailing address
113 NORH 6 MILE LANE, FORT GIBSON, OK 74434
(918) 869-0089
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
3257
OK
Other
Enumeration date
05/11/2022
Last updated
05/11/2022
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