Individual
JILL JEANNINE ABBOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801A S LEE ST, FORT GIBSON, OK 74434-8710
(918) 478-4433
Mailing address
PO BOX 1828, FORT GIBSON, OK 74434-1828
(918) 478-4433
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1614
OK
Other
Enumeration date
05/16/2022
Last updated
05/16/2022
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