Individual
JACOB BRISCO LOCKLEAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4306 LUDGATE ST, LUMBERTON, NC 28358-2461
(910) 671-4601
Mailing address
4306 LUDGATE ST, LUMBERTON, NC 28358-2461
(910) 671-4601
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13772
NC
Other
Enumeration date
06/24/2024
Last updated
06/24/2024
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