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Jerry Jack, DDS
NPI 1265463467 · on the registry since 2006
Practice
- Address
- 1740 N Service Rd
Moore, OK 73160 - Phone
- (405) 794-7200
- Fax
- (405) 794-2266
- Organisation at this address
- Ronald Montgomery Dental Group, Pc
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 1223G0001X
1223G0001X
- Licence states on file
- OK
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oklahoma