Individual
JACOB GREGORY YETZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.D.S
Contact information
Practice address
251 RADIO DRIVE, SUITE A, WOODBURY, MN 55125-0001
(651) 760-3661
Mailing address
251 RADIO DRIVE, SUITE A, WOODBURY, MN 55125-0001
(651) 760-3661
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S93
MN
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
ME119107
FL
Other
Enumeration date
06/02/2008
Last updated
12/11/2024
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