Organization
PEAK DENTAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF A JACKSON (CHIEF OPERATING OFFICER)
(918) 408-6228
Entity
Organization
Contact information
Practice address
4 N COO Y YAH ST, PRYOR, OK 74361-3820
(918) 825-0822
Mailing address
4 N COO Y YAH ST, PRYOR, OK 74361-3820
(918) 825-0822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/24/2011
Last updated
05/24/2011
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