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Individual

DR. JACOB SCHLEE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
101 E BROADWAY BLVD, JOHNSTON CITY, IL 62951-1602
(618) 983-6961
Mailing address
15378 HARRIS SCHOOL RD, JOHNSTON CITY, IL 62951-2807

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IL

Other

Enumeration date
03/04/2007
Last updated
07/08/2007
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