Individual
MRS. LAURIE BETH JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8627 CINNAMON CREEK DR BLDG 401, THE OMO GROUP, SAN ANTONIO, TX 78240
(210) 691-5116
(210) 691-5122
Mailing address
6834 ARIEL DR, JACKSONVILLE, FL 32277-2634
(904) 745-3220
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
DH15572
FL
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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