Jacob Scott Bleyer, DMD, MS Valid NPI

Individual provider · Orthodontics and Dentofacial Orthopedics Dentistry · O'Fallon, MO

NPI

1861912891

Type

Individual (Type 1)

Primary specialty

Orthodontics and Dentofacial Orthopedics Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223X0400X

License number

2019014884 (MO)

Sex

Male

Sole proprietor

No

Enumerated

2017-06-21

Last updated

2024-03-25