Steven Gary Jacob D.M.D

NPI 1053570200 - Dentist - 122300000X

NPI Details
NPI 1053570200
Gender Male
Enumeration Date 06/03/2008
Last Updated 06/03/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
7210 MAPLECREST RD
FORT WAYNE IN, 46835-1892, US
Phone (260) 485-5530
Fax (260) 485-8344
Business Location
7210 MAPLECREST RD
FORT WAYNE IN, 46835-1892, US
Phone (260) 485-5530
Fax (260) 485-8344
Toxanomy
Taxonomy Code 122300000X
License State Indiana
License Number 12010605A
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According to our database, Dr. Steven Gary Jacob D.M.D NPI is 1053570200, taxonomy code is 122300000X and license number is 12010605A, license state is located at Indiana. Steven Gary Jacob D.M.D physically located at 7210 Maplecrest Rd, Fort Wayne IN, 46835-1892. NPI Number Steven Gary Jacob D.M.D has the Individual type.

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1053570200 NPI number is provided on an as is basis without warranty of any kind. 1053570200 is maintained by the National Plan & Provider Enumeration System. The contents of Steven Gary Jacob D.M.D are for informational purposes only.