Individual
JACOB SCOTT BLEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
3006 HIGHWAY K, O'FALLON, MO 63368-8675
(636) 978-8848
(636) 294-4059
Mailing address
3006 HIGHWAY K, O'FALLON, MO 63368-8675
(636) 978-8848
(636) 294-4059
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
021.003008
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2019014884
MO
Other
Enumeration date
06/21/2017
Last updated
03/25/2024
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