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Individual

DR. JILLIAN RENAE PRATHER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
12814 E 101ST PL N, #101, OWASSO, OK 74055-4662
(918) 274-4466
Mailing address
12814 E 101ST PL N, #101, OWASSO, OK 74055-4662

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6852
OK

Other

Enumeration date
06/23/2016
Last updated
06/23/2016
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