JACOB ITSKOVICH

FARMINGTON, CT
NPI1194350140
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
(Licence: CT  12877)
Enumeration Date2020-03-10
Last Update Date2020-08-04
Business Address
JACOB ITSKOVICH DMD
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2000
Mailing Address
JACOB ITSKOVICH DMD
6855 LEYTONSTONE BLVD
WEST BLOOMFIELD, MI 48322-1243
Phone number: 248-303-5919
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