Provider Demographics
NPI:1467866533
Name:BRAMMER, JEFFREY JR (DDS)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:
Last Name:BRAMMER
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 PARKWOODS DR
Mailing Address - Street 2:NONE
Mailing Address - City:NOBLE
Mailing Address - State:OK
Mailing Address - Zip Code:73068-9391
Mailing Address - Country:US
Mailing Address - Phone:405-872-9597
Mailing Address - Fax:
Practice Address - Street 1:1009 PARKWOODS DR
Practice Address - Street 2:NONE
Practice Address - City:NOBLE
Practice Address - State:OK
Practice Address - Zip Code:73068-9391
Practice Address - Country:US
Practice Address - Phone:405-872-9597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-17
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK65801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice