Lawrence T Jacobs DDS PC

Organization Active NPI General Practice Dentistry · River Grove, IL

NPI 1710041249 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1710041249
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
LAWRENCE T JACOBS DDS PC
Practice address
8235 Grand Ave
River Grove, IL 60171-1539
Phone
(708) 453-0250
NPI assigned
Dec 20, 2006
Organization subpart
No

Authorized official

Name
Dr. Lawrence T Jacobs, DDS
Title
President Owner
Phone
(708) 453-0250

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

8235 Grand Ave
River Grove, IL 60171
Phone (708) 453-0250

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X IL Yes

Addresses

Primary practice location

8235 Grand Ave
River Grove, IL 60171-1539

Mailing address

8235 Grand Ave
River Grove, IL 60171-1539
Phone (708) 453-0250

Other providers in River Grove, IL

All providers in River Grove, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.