Individual
DR. GERALD BRETT ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
421 E. 5TH ST., OKMULGEE, OK 74447
(918) 493-7445
(918) 295-6194
Mailing address
421 E. 5TH ST., OKMULGEE, OK 74447
(918) 587-2171
(918) 295-6194
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5044
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100125080A
—
OK
Enumeration date
08/09/2006
Last updated
12/03/2013
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