Individual
DR. JONAH R.B. VANDIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7104 S SHERIDAN, SUITE 8, TULSA, OK 74133
(918) 492-1917
(918) 492-4538
Mailing address
7104 S SHERIDAN, SUITE 8, TULSA, OK 74133
(918) 492-1917
(918) 492-4538
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5392
OK
Other
Enumeration date
02/20/2007
Last updated
07/08/2007
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