Individual
JACOB WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
100 BOUCK AVE, GRAND LEDGE, MI 48837-1606
(517) 256-9840
Mailing address
100 BOUCK AVE, GRAND LEDGE, MI 48837-1606
(517) 256-9840
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901021607
MI
Other
Enumeration date
07/09/2015
Last updated
07/09/2015
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