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1275150658
JACOB WILEY-BLUE HOLTZCLAW
ALBANY, GA
NPI
1275150658
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: GA DN016080)
Enumeration Date
2020-07-01
Last Update Date
2020-07-01
Business Address
JACOB WILEY-BLUE HOLTZCLAW DMD
1725 DAWSON RD
ALBANY, GA 31707-3362
Phone number: 229-883-7891
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Mailing Address
JACOB WILEY-BLUE HOLTZCLAW DMD
315 PHILEMA RD APT 15
ALBANY, GA 31701-1245
Phone number: 770-815-0655
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