Jacobs, Timothy Lee
Jacobs, Timothy Lee is an sole proprietor health care provider with primary practice located at 2916 W Stolley Park Rd Suite B, Grand Island NE 68801-6807. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Jacobs, Timothy Lee can be contacted via phone (308) 382-6660.Contact Information
Primary practice address
2916 W Stolley Park Rd Suite B
Grand Island NE 68801-6807
Phone: (308) 382-6660
Fax: (308) 381-9809
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 5487 NE | Nebraska |
Profile Details
| NPI number | 1609951458 |
|---|---|
| LBN Legal business name | Jacobs, Timothy Lee |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 26th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1609951458 | NPPES |
| Nebraska | MEDICAID | 47070582700 |
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