Individual
DR. TODD MICHAEL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
200 ALBERT SABIN WAY, CINCINNATI, OH 45267-2800
(859) 394-2899
Mailing address
406 SHANNON DR, EDGEWOOD, KY 41017-3353
(859) 394-2899
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
10394
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2015
Last updated
03/07/2022
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