Individual
JACOB FOUTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
806 E JACKSON ST, MEDFORD, OR 97504-6773
(541) 734-5225
(541) 734-5225
Mailing address
826 E MAIN ST, MEDFORD, OR 97504-7134
(541) 858-0740
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10292
OR
Other
Enumeration date
07/09/2015
Last updated
03/17/2018
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