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Individual

DR. STEVEN GARY JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.M.D

Contact information

Practice address
7210 MAPLECREST RD, FORT WAYNE, IN 46835-1892
(260) 485-5530
(260) 485-8344
Mailing address
7210 MAPLECREST RD, FORT WAYNE, IN 46835-1892
(260) 485-5530
(260) 485-8344

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010605A
IN

Other

Enumeration date
06/03/2008
Last updated
06/03/2008
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