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Individual
STEPHEN ERIC JACOBSON
Active
Individual
STEPHEN ERIC JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S. PC
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
14257
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
723815
UNITED CONCORDIA
MI
Enumeration date
08/07/2006
Last updated
05/04/2022
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