Individual
ANN T. JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
122 COLFAX AVE SW, WADENA, MN 56482-1470
(218) 631-4525
Mailing address
122 COLFAX AVE SW, WADENA, MN 56482-1470
(218) 631-4525
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
6239
WI
122300000X
Dentist
Primary
D12563
MN
Other
Enumeration date
06/10/2008
Last updated
08/03/2012
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