Individual
DR. JACOB EARL HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
307 S MAIN ST, GALLATIN, MO 64640-1339
(660) 663-2814
(660) 663-2822
Mailing address
307 S MAIN ST, GALLATIN, MO 64640-1339
(660) 663-2814
(660) 663-2822
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2012015443
MO
Other
Enumeration date
05/24/2012
Last updated
05/24/2012
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