DR. Jacob Daniel Carlisle, DDS

NPI #1437718301 in Benton Harbor, Michigan

Provider Information

NPI Number: 1437718301
Entity Type: Individual
Name: DR. Jacob Daniel Carlisle, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jun 13, 2019
Last Updated: Jun 13, 2019

Practice Location

Address: 800 M 139
City: Benton Harbor
State: Michigan
ZIP Code: 49022-3881
Phone: (855) 869-6900

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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