# T GREGORY JACOBS DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114143120
- **Authorized official:** T GREGORY JACOBS DDS (PRESIDENT OWNER)
- **Authorized official phone:** (813) 310-9580

## Contact information

- **Practice address:** 4208 W BAY TO BAY BLVD, TAMPA, FL 33629-6608
- **Practice address phone:** (813) 657-3000
- **Mailing address:** 4208 W BAY TO BAY BLVD, TAMPA, FL 33629-6608
- **Mailing address phone:** (813) 657-3000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0700X | Prosthodontics | — | — | Yes |

## Other

- **Enumeration date:** 04/18/2007
- **Last updated:** 01/13/2016