Individual
DR. JACOB DALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
705 E MCDOWELL RD, PHOENIX, AZ 85006-2519
(602) 258-4865
Mailing address
1100 N PRIEST DR, APT. 2024, CHANDLER, AZ 85226-1004
(314) 805-7586
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S018634
AZ
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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