Individual
DR. JEROMY WADE DAUPHIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1024 SW 104TH ST, OKLAHOMA CITY, OK 73139-2990
(405) 691-1123
(405) 691-2674
Mailing address
1024 SW 104TH ST, OKLAHOMA CITY, OK 73139-2990
(405) 691-1123
(405) 691-2674
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
24108
TX
122300000X
Dentist
Primary
6141
OK
Other
Enumeration date
09/25/2008
Last updated
09/10/2009
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