Jacob Lee Dvorak, DT

NPI #1174968028 in Mankato, Minnesota

Provider Information

NPI Number: 1174968028
Entity Type: Individual
Name: Jacob Lee Dvorak, DT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Therapist
Credential: DT
Enumeration Date: May 6, 2013
Last Updated: May 6, 2013

Practice Location

Address: 309 HOLLY LN
City: Mankato
State: Minnesota
ZIP Code: 56001-5422
Phone: (507) 388-2120

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Therapist	125J00000X	Primary

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