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Organization
KENTUCKY DENTAL ANESTHESIA SERVICES
Active
Organization
KENTUCKY DENTAL ANESTHESIA SERVICES
Active
Other names
Kentucky Dental Anesthesia Services
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JACOBSON DMD (MEMBER)
(859) 420-9187
Entity
Organization
Contact information
Practice address
1006 ACE DR, BEREA, KY 40403-1327
(859) 420-9187
Mailing address
1006 ACE DR, BEREA, KY 40403-1327
(859) 420-9187
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
NULL
207L00000X
Anesthesiology Physician
Primary
—
—
207LP3000X
Pediatric Anesthesiology Physician
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
NULL
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
07/12/2023
Last updated
10/30/2024
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