Healthcare Provider Details

I. General information

NPI: 1619991213
Provider Name (Legal Business Name): DR PAUL J JACOBS DDS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 S LINCOLN RD
ESCANABA MI
49829-1210
US

IV. Provider business mailing address

429 S LINCOLN RD
ESCANABA MI
49829-1210
US

V. Phone/Fax

Practice location:
  • Phone: 906-786-7878
  • Fax: 906-786-0548
Mailing address:
  • Phone: 906-786-7878
  • Fax: 906-786-0548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13612
License Number StateMI

VIII. Authorized Official

Name: DR. PAUL J JACOBS
Title or Position: DR./ DENTIST
Credential: D.D.S.
Phone: 906-786-7878