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1124537667
MARY JACOB
REVERE, MA
NPI
1124537667
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: MA DN1857754)
Enumeration Date
2017-09-27
Last Update Date
2017-09-27
Business Address
Dr. MARY JACOB DMD
334 BROADWAY
REVERE, MA 02151-5016
Phone number: 178-162-9624
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Mailing Address
Dr. MARY JACOB DMD
99 FLORENCE STREET APT 102
MALDEN, MA 02148
Phone number: 203-548-1113
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