# ABY A JACOB, DMD, PC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Dental Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891041463
- **Authorized official:** DR. ABY A JACOB D.M.D. (PRESIDENT)
- **Authorized official phone:** (972) 939-6500

## Contact information

- **Practice address:** 1012 W HEBRON PKWY, SUITE 108, CARROLLTON, TX 75010-1122
- **Practice address phone:** (972) 939-6500
- **Practice address fax:** (972) 939-5300
- **Mailing address:** 1012 W HEBRON PKWY, SUITE 108, CARROLLTON, TX 75010-1122
- **Mailing address phone:** (972) 939-6500
- **Mailing address fax:** (972) 939-5300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 20704 | TX | Yes |
| 1223G0001X | General Practice Dentistry | 20704 | TX | — |

## Other

- **Enumeration date:** 08/01/2012
- **Last updated:** 08/01/2012