Individual
JACK T DANCER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 W 6TH AVE, SUITE 105, STILLWATER, OK 74074-4375
(405) 533-1074
Mailing address
1301 W 6TH AVE, SUITE 105, STILLWATER, OK 74074-4375
(405) 533-1074
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
7845
OK
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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