Organization
JERRY D MCCAN DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY D MCCAN DDS (OWNER)
(405) 381-2303
Entity
Organization
Contact information
Practice address
7 CEDAR SPRINGS DRIVE, TUTTLE, OK 73089-7929
(405) 381-2303
(405) 381-2304
Mailing address
7 CEDAR SPRINGS DRIVE, TUTTLE, OK 73089-7929
(405) 381-2303
(405) 381-2304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4124
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100106100B
—
OK
Enumeration date
06/02/2008
Last updated
06/02/2008
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