Individual
DR. JACOB JOHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
156 ROUTE 59 STE A1, SUFFERN, NY 10901-5013
(845) 356-8844
(845) 547-2218
Mailing address
9 DUNMORE RD, NEW CITY, NY 10956-4407
(917) 742-3081
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
054091
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054091
NEW YORK STATE DENTAL LICENSE
NY
Enumeration date
08/12/2008
Last updated
03/27/2026
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