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Organization
THE JACOB DENTAL GROUP INC
Active
Organization
THE JACOB DENTAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD F JACOB (OWNER)
(386) 445-6111
Entity
Organization
Contact information
Practice address
17 OLD KINGS RD N, SUITE H, PALM COAST, FL 32137-8282
(386) 445-6111
Mailing address
17 OLD KINGS RD N, SUITE H, PALM COAST, FL 32137-8282
(386) 445-6111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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