Highland Park Oms

NPI #1912283730 in Highland Park, Illinois

Provider Information

NPI Number
1912283730
Entity Type
Organization
Organization Name
Highland Park Oms
Primary Specialty
Dentist - Oral and Maxillofacial Surgery
Enumeration Date
Oct 25, 2011
Last Updated
Oct 25, 2011

Practice Location

Address
1893 SHERIDAN RD
Address 2
SUITE 311
ZIP Code
60035-2628
Phone
(847) 433-6636

Authorized Official

Name
DR. MARK B JACOB, DDS, MS
Title
OWNER
Phone
(847) 433-6636

Specialties & Taxonomy Codes

Specialty
Dentist - Oral and Maxillofacial SurgeryOral and Maxillofacial Surgery

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