Individual
DR. JACOB JOSE KURUVILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1110 S CESAR CHAVEZ BLVD APT 3050, DALLAS, TX 75201-6089
(631) 742-9840
Mailing address
11613 N CENTRAL EXPY STE 111A, DALLAS, TX 75243-3808
(631) 742-9840
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
33117
TX
122300000X
Dentist
DS041245
PA
Other
Enumeration date
06/14/2017
Last updated
07/21/2022
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