Individual
JERRY LEE DENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.PH.
Contact information
Practice address
1549 MAIN STREET, WAYNOKA, OK 73860-2008
(580) 824-1741
Mailing address
1116 FLYNN ST, WAYNOKA, OK 73860-2525
(580) 824-4881
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9252
OK
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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