Organization
LAWRENCE T JACOBS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE T JACOBS DDS (PRESIDENT OWNER)
(708) 453-0250
Entity
Organization
Contact information
Practice address
8235 GRAND AVE, RIVER GROVE, IL 60171-1539
(708) 453-0250
Mailing address
8235 GRAND AVE, RIVER GROVE, IL 60171-1539
(708) 453-0250
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
12/20/2006
Last updated
08/22/2020
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