Individual
DR. JOAN MARIE JAKUBAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4721 HIAWATHA AVE, MINNEAPOLIS, MN 55406-3928
(612) 721-3012
(612) 721-5106
Mailing address
4721 HIAWATHA AVE, MINNEAPOLIS, MN 55406-3928
(612) 721-3012
(612) 721-5106
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
10142
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
012466
UCARE
MN
01
—
45616JA
BLU CROSS BLUE SHIELD MN
MN
01
—
836516
UNITED CONCORDIA
MN
01
—
Z97489
BLUE CROSS BLUE SHIELD MA
MA
Enumeration date
09/27/2006
Last updated
07/09/2007
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