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Individual

DR. AMELIA C. JACOBS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.M.D.

Contact information

Practice address
4816 GREENWOOD RD, LOUISVILLE, KY 40258-3634
(502) 935-7212
(502) 937-8447
Mailing address
15213 CRYSTAL SPRINGS WAY, LOUISVILLE, KY 40245-5285
(502) 245-0189
(502) 937-8447

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
5179
KY

Other

Enumeration date
07/20/2006
Last updated
07/08/2007
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