Provider Demographics
NPI:1205892411
Name:YOUREE, GARY EUGENE (DDS)
Entity type:Individual
Prefix:DR
First Name:GARY
Middle Name:EUGENE
Last Name:YOUREE
Suffix:
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 1:511 E 2ND ST
Mailing Address - Street 2:P.O. BOX 100
Mailing Address - City:HEAVENER
Mailing Address - State:OK
Mailing Address - Zip Code:74937-3419
Mailing Address - Country:US
Mailing Address - Phone:918-653-4808
Mailing Address - Fax:918-653-4772
Practice Address - Street 1:511 E 2ND ST
Practice Address - Street 2:
Practice Address - City:HEAVENER
Practice Address - State:OK
Practice Address - Zip Code:74937-3419
Practice Address - Country:US
Practice Address - Phone:918-653-4808
Practice Address - Fax:918-653-4772
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK36211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice