# ERIC E JACOBSEN DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ERIC E JACOBSEN DDS PC
- **Other names:** Jacobsen Pediatric Dentistry, Sunnyside Dentistry for Children
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1225678139
- **Legal business name:** ERIC E JACOBSEN DDS PC
- **Authorized official:** DR. ERIC JACOBSEN DDS (OWNER)
- **Authorized official phone:** (443) 562-5564

## Contact information

- **Practice address:** 19502 MOLALLA AVE STE 109, OREGON CITY, OR 97045-4513
- **Practice address phone:** (503) 656-0405
- **Practice address fax:** (503) 344-4295
- **Mailing address:** 19502 MOLALLA AVE STE 109, OREGON CITY, OR 97045-4513
- **Mailing address phone:** (503) 656-0405
- **Mailing address fax:** (503) 344-4295

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 01/08/2020
- **Last updated:** 01/08/2020