Individual
JACY RAE GLOVER-SECREST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
700 S EASTERN AVE, MOORE, OK 73160-6199
(405) 912-3300
Mailing address
9301 STRAKA RD, OKLAHOMA CITY, OK 73165-9630
(405) 623-3735
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7301
OK
122300000X
Dentist
T7301
OK
1223G0001X
General Practice Dentistry
Primary
7301
OK
Other
Enumeration date
06/18/2020
Last updated
08/25/2025
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