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Dr. Jacob Caine Dachman, DMD
Student in an Organized Health Care Education/Training Program in Rockford, Illinois
NPI 1669054839

Jacob Caine Dachman is a Student in an Organized Health Care Education/Training Program based in Lake In The Hills, IL. Jacob Caine Dachman practices in Rockford, IL and has the professional credentials of DMD. The NPI Number for Jacob Caine Dachman is 1669054839 and holds a License No. 021.003272 (Illinois).

The current practice location address for Jacob Caine Dachman is 4903 E State St, Rockford, IL and can be reached out via phone at 815-398-2323. You can also correspond with Jacob Caine Dachman through the mailing address at 5 LA QUINTA CT, LAKE IN THE HILLS, IL - 60156-4490 (mailing address contact number: ).

Location: 4903 E State St, Rockford, IL, 60156-4490
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1669054839
Provider Name
Jacob Caine Dachman
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
4903 E State St, Rockford, IL, 60156-4490
Phone Number
815-398-2323
Fax Number
Provider Enumeration Date
04/26/2021
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
4903 E State St
City
Rockford
State
Illinois
Zip
61108-2276
Phone Number
815-398-2323
Fax Number
person
Provider Business Mailing Address Details
Address
4903 E State St
City
Rockford
State
Illinois
Zip
61108-2276
Phone Number
815-398-2323
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
()
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
021.003272 (Illinois)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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