Individual
GEORGE JERYN JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MDS, MS
Contact information
Practice address
1180 N PRESTON RD STE 20, PROSPER, TX 75078-9291
(972) 426-8770
Mailing address
15922 ELDORADO PKWY STE 500-1756, FRISCO, TX 75035-5836
(214) 729-0426
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
36475
TX
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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