Organization
JERRY L. THORMAN, DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JERRY L. THORMAN DDS (PRESIDENT)
(918) 756-4933
Entity
Organization
Contact information
Practice address
500 E 8TH ST, OKMULGEE, OK 74447-5503
(918) 756-4933
(918) 756-7781
Mailing address
500 E 8TH ST, OKMULGEE, OK 74447-5503
(918) 756-4933
(918) 756-7781
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3202
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100122240A
—
OK
Enumeration date
04/23/2008
Last updated
04/23/2008
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