JACOB LEE DMD, MD
Individual Provider (NPI-1)
Active
Oral & Maxillofacial Surgery
Provider Information
- NPI Number
1912438805- Provider Type
- Individual Provider (NPI-1)
- Credentials
- DMD, MD
- Status
- Active
Contact & Location
- Address
- 1260 HIGHWAY 54 STE 200, FAYETTEVILLE, GA, 302144513
- Phone
- (770) 461-2101
Specialties & Taxonomies
Oral & Maxillofacial Surgery
Primary License: GA #94785
Dentist, Oral and Maxillofacial Surgery
License: GA #DN122602