Provider Demographics
NPI:1073948113
Name:IRA A JACOBS DMD
Entity Type:Organization
Organization Name:IRA A JACOBS DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IRA
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-337-4666
Mailing Address - Street 1:9 POST RD
Mailing Address - Street 2:SUITE D8
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-1618
Mailing Address - Country:US
Mailing Address - Phone:201-337-4666
Mailing Address - Fax:201-337-9090
Practice Address - Street 1:9 POST RD
Practice Address - Street 2:SUITE D8
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-1618
Practice Address - Country:US
Practice Address - Phone:201-337-4666
Practice Address - Fax:201-337-9090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty