Individual
JAKE BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7221 NW 23RD ST UNIT C-D, BETHANY, OK 73008-5131
(405) 367-8147
Mailing address
301 W KINGS RD, ADA, OK 74820-8219
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
7560
OK
Other
Enumeration date
04/23/2022
Last updated
02/19/2026
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