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Individual

JACOB AARON FREEZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
3278 MITCHELL BLVD BLDG 900, MOODY AFB, GA 31699-5529
(229) 257-1459
Mailing address
3278 MITCHELL BLVD BLDG 900, MOODY AFB, GA 31699-1500
(229) 257-3136

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
61090426
WA

Other

Enumeration date
04/01/2020
Last updated
04/01/2022
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