Provider Demographics
NPI:1689772451
Name:JACOBYANSKY, FRANCIS ADOLPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:FRANCIS
Middle Name:ADOLPH
Last Name:JACOBYANSKY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 JIM MOUNTAIN ROAD
Mailing Address - Street 2:
Mailing Address - City:NORMALVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15469-0123
Mailing Address - Country:US
Mailing Address - Phone:724-455-7421
Mailing Address - Fax:
Practice Address - Street 1:2 JIM MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:NORMALVILLE
Practice Address - State:PA
Practice Address - Zip Code:15469-0123
Practice Address - Country:US
Practice Address - Phone:724-455-7421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023122L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice