Individual
DR. JEFFREY GREG BROERMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6585 S YALE AVE STE 510, TULSA, OK 74136
(918) 492-1106
Mailing address
6585 S YALE AVE STE 510, TULSA, OK 74136-8384
(918) 492-1106
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5738
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200084840A
—
OK
Enumeration date
12/11/2006
Last updated
12/12/2019
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