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Individual

DR. JACOB B MACKEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
603 S 1ST ST, LAMAR, CO 81052-3205
(719) 336-7719
(719) 336-0368
Mailing address
603 S 1ST ST, LAMAR, CO 81052-3205
(719) 336-7719
(719) 336-0368

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00202287
CO

Other

Enumeration date
06/07/2012
Last updated
08/14/2014
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