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Contact Information

JACOB E FRAZIER, DMD, MS
110 WAKANDA DR
LEBANON, IL62254-1393
 Phone: 618-808-0511
 Fax: 618-808-0533
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
 

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for JACOB E FRAZIER · (Male)

NPI # 1497043178
Status Active
Credentials DMD, MS
Entity Individual
Enumeration date 07/15/2011
Last updated 07/19/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 019028757
  • IL License # 021.002661
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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