# JACOB GREGORY YETZER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1588823983
- **Gender:** Man
- **Credential:** M.D., D.D.S

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | S93 | MN | Yes |
| 204E00000X | Oral & Maxillofacial Surgery (D.M.D.) | ME119107 | FL | — |

## Other

- **Enumeration date:** 06/02/2008
- **Last updated:** 12/11/2024