Individual
TANNER NIELSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1408 N SIOUX AVE, CLAREMORE, OK 74017-3126
(918) 921-9583
Mailing address
1408 N SIOUX AVE, CLAREMORE, OK 74017-3126
(918) 921-9583
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7887
OK
Other
Enumeration date
05/25/2023
Last updated
05/06/2024
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