Individual
DR. JERRY BOB NICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1015 E 6TH ST, OKMULGEE, OK 74447-4705
(918) 758-0022
(918) 756-2046
Mailing address
1015 E 6TH ST, OKMULGEE, OK 74447-4705
(918) 758-0022
(918) 756-2046
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4701
OK
Other
Enumeration date
08/18/2006
Last updated
07/08/2007
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