Individual
DR. BRADLEY JOHN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS MS
Contact information
Practice address
1005 EXECUTIVE DR, SUITE 105, HIXSON, TN 37343-7903
(423) 877-1286
(423) 877-1290
Mailing address
1005 EXECUTIVE DR, SUITE 105, HIXSON, TN 37343-7903
(423) 877-1286
(423) 877-1290
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS8742
TN
Other
Enumeration date
09/06/2006
Last updated
09/21/2009
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