Individual
DR. JACOB SIMONOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
N85W16093 APPLETON AVE, MENOMONEE FALLS, WI 53051-3088
(262) 253-9797
Mailing address
N85W16093 APPLETON AVE, MENOMONEE FALLS, WI 53051-3088
(262) 253-9797
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001324-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2016
Last updated
12/13/2016
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