Jacob Eldon Frazier, DMD, MS

NPI #1497043178 in Lebanon, Illinois

Provider Information

NPI Number: 1497043178
Entity Type: Individual
Name: Jacob Eldon Frazier, DMD, MS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Endodontics
Credential: DMD, MS
Enumeration Date: Jul 15, 2011
Last Updated: Jul 19, 2023

Practice Location

Address: 110 WAKANDA DR
City: Lebanon
State: Illinois
ZIP Code: 62254-1393
Phone: (618) 808-0511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X
Dentist - Endodontics — Endodontics	1223E0200X	Primary

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