Individual
DR. JACOB MATTHEW PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
5843 SW 85TH ST, GAINESVILLE, FL 32608-8526
(619) 787-2148
Mailing address
5843 SW 85TH ST, GAINESVILLE, FL 32608-8526
(619) 787-2148
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1227
FL
Other
Enumeration date
07/13/2013
Last updated
07/13/2013
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