Provider Demographics
NPI:1477046472
Name:URAM, JACOB HARRISON (DDS)
Entity type:Individual
Prefix:DR
First Name:JACOB
Middle Name:HARRISON
Last Name:URAM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:232 DOVE RUN CENTRE DR
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19709-7971
Mailing Address - Country:US
Mailing Address - Phone:302-449-6810
Mailing Address - Fax:302-449-6222
Practice Address - Street 1:232 DOVE RUN CENTRE DR
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-7971
Practice Address - Country:US
Practice Address - Phone:302-449-6810
Practice Address - Fax:302-449-6222
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-13
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00014571223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program