Individual
DR. JARROD DON LACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1710 W WILLOW RD, ENID, OK 73703-2438
(580) 234-6663
Mailing address
1710 W WILLOW RD, ENID, OK 73703-2438
(580) 234-6663
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6916
OK
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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