Jacobs, Barry T

Jacobs, Barry T is an individual health care provider with primary practice located at 615 Lake Shore Dr W , Ashland WI 54806-1507. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Jacobs, Barry T can be contacted via phone (715) 682-2811.

Contact Information

Primary practice address
615 Lake Shore Dr W Ashland WI 54806-1507
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 4283-15 Wisconsin

Profile Details

NPI number 1508922428
LBN Legal business name Jacobs, Barry T
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 28th, 2006
Last updated Mar 7th, 2023 - about last year

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 1508922428 NPPES
Wisconsin MEDICAID 33709000

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