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1750951489
JACOB ALEXANDER FANT
RICHMOND, VA
NPI
1750951489
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: VA 0401417475)
Enumeration Date
2021-06-25
Last Update Date
2021-06-25
Business Address
Dr. JACOB ALEXANDER FANT DMD
520 N 12TH ST
RICHMOND, VA 23298-5064
Phone number: 804-828-7767
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Mailing Address
Dr. JACOB ALEXANDER FANT DMD
12506 MANDOLIN DR
MIDLOTHIAN, VA 23113-2805
Phone number: 703-677-4229
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