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Individual
JACOB WESLEY LANDON
Active
Individual
JACOB WESLEY LANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS045577
PA
1223G0001X
General Practice Dentistry
6001486-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
04/29/2024
Last updated
04/06/2026
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