Eric P Jacobi, DDS

Individual provider Active NPI General Practice Dentistry · Robesonia, PA

NPI 1093887341 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1093887341
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DS020392L (PA)
Practice address
105 W Penn Ave
Robesonia, PA 19551
Phone
(610) 693-6508
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DS020392LPAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS020392L PA Yes

Addresses

Primary practice location

105 W Penn Ave
Robesonia, PA 19551

Mailing address

105 W Penn Ave
Robesonia, PA 19551
Phone (610) 693-6508

Other identifiers

IdentifierTypeStateIssuer
DS020392LOtherPADENTAL LICENSE COMMONWEAL

Other providers in Robesonia, PA

All providers in Robesonia, PA · General Practice Dentistry in Pennsylvania

Sources for this page

Verify at the official NPI Registry.