Individual
JACOB FILLEBROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
324 GANNETT DR STE 500, SOUTH PORTLAND, ME 04106-3361
(207) 253-5600
Mailing address
324 GANNETT DR STE 500, SOUTH PORTLAND, ME 04106-3361
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DEN4562
ME
Other
Enumeration date
06/23/2017
Last updated
06/23/2017
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