Individual
DR. JEFFREY T JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
906 ROYAL CT, MEDFORD, OR 97504
(541) 414-0519
(541) 842-7774
Mailing address
1000 E MAIN ST, MEDFORD, OR 97504-7667
(541) 414-0519
(541) 842-7774
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10806
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D10806
STATE LICENSE NUMBER
OR
Enumeration date
08/07/2009
Last updated
07/03/2018
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