Individual
ALAN TODD JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
484 WASHINGTON AVE, BELLEVILLE, NJ 07109-2688
(973) 759-1010
(973) 759-2411
Mailing address
484 WASHINGTON AVE, BELLEVILLE, NJ 07109-2688
(973) 759-1010
(973) 759-2411
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
22277
NJ
Other
Enumeration date
05/04/2010
Last updated
05/04/2010
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