Individual
JACOB DANIEL MEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12904 CENTRAL AVE NE, BLAINE, MN 55434-4147
(763) 755-1330
Mailing address
854 104TH LN NE, BLAINE, MN 55434-1556
(651) 707-6607
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D14782
MN
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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