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1053570200
STEVEN GARY JACOB
FORT WAYNE, IN
NPI
1053570200
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IN 12010605a)
Enumeration Date
2008-06-03
Last Update Date
2008-06-03
Business Address
Dr. STEVEN GARY JACOB D.M.D
7210 MAPLECREST RD
FORT WAYNE, IN 46835-1892
Phone number: 260-485-5530
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Mailing Address
Dr. STEVEN GARY JACOB D.M.D
7210 MAPLECREST RD
FORT WAYNE, IN 46835-1892
Phone number: 260-485-5530
Copy
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