Individual
LESLIE T JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
811 EAST MAIN STREET, SPARTANBURG, SC 29302
(864) 573-9254
(864) 573-5416
Mailing address
811 EAST MAIN STREET, SPARTANBURG, SC 29302
(864) 573-9254
(864) 573-5416
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1638
SC
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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