Individual
JAKE LAXER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4881 SUGAR MAPLE DR, WPAFB, OH 45433-5529
(937) 257-8761
Mailing address
88TH MEDICAL GROUP, 4881 SUGAR MAPLE DR., WPAFB, OH 45433
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11866
NC
Other
Enumeration date
04/28/2020
Last updated
08/13/2025
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