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Individual

JACOB GRIFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1344 CARMICHAEL WAY, MONTGOMERY, AL 36106-3694
(334) 244-2055
(334) 244-2059
Mailing address
1344 CARMICHAEL WAY, MONTGOMERY, AL 36106-3694
(334) 244-2055
(334) 244-2059

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4786AL
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009957260
AL
Enumeration date
01/31/2007
Last updated
04/12/2013
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