Most Relevant Information
Provider Data
| NPI Number: | 1003336702 |
| Provider Name: | JACOB FILLEBROWN DMD |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | DEN4562 |
Most Important Dates
| Enumeration Date: | 06/23/2017 |
| Last Updated: | 06/23/2017 |
Provider Practice Location
324 GANNETT DR STE 500
SOUTH PORTLAND
ME
041063361
Practice Location Phone/Fax
| Phone: | 2072535600 |
| Fax: |
Provider Mailing Location
324 GANNETT DR STE 500
SOUTH PORTLAND
ME
041063361
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |