Search › Illinois › 1223E0200X
Jacob Frazier, DMD, MS
NPI 1497043178 · on the registry since 2011 · sole proprietor
Practice
- Address
- 110 Wakanda Dr
Lebanon, IL 62254 - Phone
- (618) 808-0511
- Fax
- (618) 808-0533
Registry record
- Primary taxonomy
- 1223E0200X
1223E0200X
- Also registered as
- 1223G0001X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2023-07-19
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois