Jacobs, Jonathan H

Jacobs, Jonathan H is an individual health care provider with primary practice located at 22811 Greater Mack Ave Ste. L-10, St Clair Shores MI 48080-2021. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jacobs, Jonathan H can be contacted via phone (586) 774-2400.

Contact Information

Primary practice address
22811 Greater Mack Ave Ste. L-10 St Clair Shores MI 48080-2021
Phone: (586) 774-2400
Fax: (586) 774-2461
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 2901012905 Michigan

Profile Details

NPI number 1972563609
LBN Legal business name Jacobs, Jonathan H
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2006
Last updated Jul 8th, 2007 - about 17 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 1972563609 NPPES
Michigan Other 689419 UNITED CONCORDIA

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