Organization
JACOB DENT DDS ELMWOOD MODERN DENTISTRY A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB DENT (OWNER)
(714) 845-8500
Entity
Organization
Contact information
Practice address
1208 S CLEARVIEW PKWY STE C, HARAHAN, LA 70123-2557
(504) 224-9093
Mailing address
PO BOX 660041, DALLAS, TX 75266-0041
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
06/02/2025
Last updated
06/02/2025
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