Individual
DR. NEVILLE KALLARACKEL JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS,DDS
Contact information
Practice address
4420 DIXIE HWY STE 110, LOUISVILLE, KY 40216-2986
(502) 447-3323
(913) 752-9116
Mailing address
7517 CELEBRATION WAY, CRESTWOOD, KY 40014
(317) 702-0660
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9859
KY
Other
Enumeration date
12/24/2009
Last updated
09/05/2017
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