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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164540233 | NPPES |
| New Jersey | MEDICAID | 91001810700 |
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