Jacob Robert Wallock, DDS
NPI #1902485725 in Fond Du Lac, Wisconsin
Provider Information
- NPI Number
- 1902485725
- Entity Type
- Individual
- Name
- Jacob Robert Wallock, DDS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - General Practice
- Credential
- DDS
- Enumeration Date
- Apr 7, 2021
- Last Updated
- Jun 17, 2021
Practice Location
- Address
- 145 S MARR ST
- City
- Fond Du Lac
- State
- Wisconsin
- ZIP Code
- 54935-4408
- Phone
- (920) 922-9000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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