Individual
JACOB KIRBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5804 NEW COPELAND RD, TYLER, TX 75703-6217
(903) 561-1610
Mailing address
5804 NEW COPELAND RD, TYLER, TX 75703-6217
(903) 561-1610
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
28111
TX
Other
Enumeration date
07/06/2012
Last updated
07/06/2012
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