Mack Jacob, DDS

NPI #1730615329 in Berkeley, California

Provider Information

NPI Number: 1730615329
Entity Type: Organization
Organization Name: Mack Jacob, DDS
Primary Specialty: Dentist
Enumeration Date: May 3, 2017
Last Updated: May 3, 2017

Practice Location

Address: 2012 PRINCE ST
City: Berkeley
State: California
ZIP Code: 94703-2519
Phone: (510) 843-8568

Authorized Official

Name: MARILYN RODRIQUEZ
Title: MANAGER
Phone: (510) 843-8568

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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