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JACOB JEFFERY WORMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 655-2000
Mailing address
726 E MARIETTA AVE, PEORIA HEIGHTS, IL 61616-6222
(309) 713-6951

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019035195
IL

Other

Enumeration date
06/24/2024
Last updated
06/24/2024
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