Organization
JACOB THAYER DDS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB BRADY THAYER DDS (PRESIDENT)
(313) 468-2162
Entity
Organization
Contact information
Practice address
820 BYRON RD, SUITE 800, HOWELL, MI 48843-1098
(517) 546-2240
Mailing address
820 BYRON RD, SUITE 800, HOWELL, MI 48843-1098
(517) 546-2240
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901019145
MI
Other
Enumeration date
09/11/2014
Last updated
09/11/2014
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