Individual
MS. LAURA L JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2795 E MAPLEWOOD AVE, CENTENNIAL, CO 80121-2869
(303) 730-8896
Mailing address
2795 E MAPLEWOOD AVE, CENTENNIAL, CO 80121-2869
(303) 730-8896
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
202056
CO
Other
Enumeration date
01/06/2020
Last updated
01/06/2020
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