Individual
PHILLIP A JAKUBOWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
103 OSCEOLA AVE, OSCEOLA, IN 46561-2209
(574) 674-8757
Mailing address
208 KRIDER DR, MIDDLEBURY, IN 46540-9018
(574) 535-3428
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012014A
IN
Other
Enumeration date
06/28/2013
Last updated
05/20/2020
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