Individual
DENNIS MICHAEL JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1741 S 20TH AVE, SAFFORD, AZ 85546-4012
(928) 348-0652
(928) 348-0695
Mailing address
1741 S 20TH AVE, SAFFORD, AZ 85546-4012
(928) 348-0652
(928) 348-0695
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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