Individual
JACOB EDWARD HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1012 W 11TH ST, PANAMA CITY, FL 32401-2042
(850) 763-6782
Mailing address
1012 W 11TH ST, PANAMA CITY, FL 32401-2042
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN26041
FL
Other
Enumeration date
06/22/2021
Last updated
06/22/2021
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