Jacob Tall
NPI #1265056121 in Idaho Falls, Idaho
Provider Information
- NPI Number
- 1265056121
- Entity Type
- Individual
- Name
- Jacob Tall
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist
- Enumeration Date
- Jun 5, 2020
- Last Updated
- Jun 5, 2020
Practice Location
- Address
- 2460 E 25TH ST
- City
- Idaho Falls
- State
- Idaho
- ZIP Code
- 83404-7549
- Phone
- (208) 525-4780
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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