Jacob, Gregg Andrew

Jacob, Gregg Andrew is an sole proprietor health care provider with primary practice located at 83 Hanover Rd Ste 240 , Florham Park NJ 07932-1508. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Jacob, Gregg Andrew can be contacted via phone (973) 360-1100.

Contact Information

Primary practice address
83 Hanover Rd Ste 240 Florham Park NJ 07932-1508
Phone: (973) 360-1100
Fax: (973) 360-1101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 22DI02252800 New Jersey
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X 054217-1 New York

Profile Details

NPI number 1164540233
LBN Legal business name Jacob, Gregg Andrew
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 27th, 2007
Last updated Mar 17th, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164540233 NPPES
New Jersey MEDICAID 91001810700

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