Individual
DR. BARRY T JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
615 LAKE SHORE DR W, ASHLAND, WI 54806-1507
(715) 682-2811
Mailing address
615 LAKE SHORE DR W, ASHLAND, WI 54806-1507
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4283-15
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33709000
—
WI
Enumeration date
12/28/2006
Last updated
03/07/2023
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