Organization
T GREGORY JACOBS DDS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
T GREGORY JACOBS DDS (PRESIDENT OWNER)
(813) 310-9580
Entity
Organization
Contact information
Practice address
4208 W BAY TO BAY BLVD, TAMPA, FL 33629-6608
(813) 657-3000
Mailing address
4208 W BAY TO BAY BLVD, TAMPA, FL 33629-6608
(813) 657-3000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0700X
Prosthodontics
Primary
—
—
Other
Enumeration date
04/18/2007
Last updated
01/13/2016
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