Individual
DR. JACK N SELLERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
103 NW 9TH ST, STIGLER, OK 74462-1700
(918) 967-4609
(918) 967-9041
Mailing address
103 NW 9TH ST, STIGLER, OK 74462-1700
(918) 967-4609
(918) 967-9041
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3574
OK
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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