MEDICARE: DR. JACOB BRIMHALL HYER D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	11323	NC
2	122300000X	Dentist	65096	CA

General Provider Information

NPI Number	:	1811366107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB BRIMHALL HYER D.D.S.

Provider Business Mailing Address
First Line	:	3101 EDWARDS MILL RD STE 103
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27612-5303
Country	:	US
Telephone Number	:	919-571-0222
Fax Number	:	919-571-0221

Provider Business Practice Location Address
First Line	:	3101 EDWARDS MILL RD STE 103
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27612-5303
Country	:	US
Telephone Number	:	919-571-0222
Fax Number	:	919-571-0221

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/17/2015
Last Update Date	:	02/22/2024

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