Individual
DR. JEFFREY CARL DANNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., PLLC
Contact information
Practice address
901 HOSPITAL CIR, KINGFISHER, OK 73750-5006
(405) 375-3857
Mailing address
901 HOSPITAL CIR, KINGFISHER, OK 73750-5006
(405) 375-3857
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5543
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100108540B
—
OK
01
—
731614925
TAX ID
OK
Enumeration date
06/29/2006
Last updated
09/22/2014
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