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Provider Information for 1386736767

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

JACOB LEIBOVICI DDS

Gender: MALE

Individual NPI: 1386736767

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1386736767
Enumeration Date 2006-09-29
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 9146 DELEMAR COURT
WELLINGTON, FL 33414
United States

Phone: 561-333-3757 | Fax: 561-427-0422
View Map External Link
Primary Practice Address 175 TEQUESTA DR
TEQUESTA, FL 33469
United States

Phone: 561-427-0420 | Fax: 561-427-0422
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 122300000X - Dentist FL DN14459