Organization
LAKEVIEW DENTAL CENTER, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY T JACOBS DDS (PRESIDENT)
(715) 682-2811
Entity
Organization
Contact information
Practice address
615 LAKE SHORE DR W, ASHLAND, WI 54806-1507
(715) 682-2811
Mailing address
615 LAKE SHORE DR W, ASHLAND, WI 54806-1507
(715) 682-2811
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
12/28/2006
Last updated
08/22/2020
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