Individual
JACOB LEE DVORAK
Active
Individual
JACOB LEE DVORAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DT
Taxonomy
Speciality
Code
Description
License number
State
125J00000X
Dental Therapist
Primary
DT23
MN
Other
Enumeration date
05/06/2013
Last updated
05/06/2013
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