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Organization
SIKORA & JACOBSEN LLC
Active
Organization
SIKORA & JACOBSEN LLC
Active
Other names
Prairie Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL JACOBSEN (PARTNER)
(309) 662-7722
Entity
Organization
Contact information
Practice address
3220 GERIG DR, BLOOMINGTON, IL 61704-6394
(309) 662-7722
Mailing address
3220 GERIG DR, BLOOMINGTON, IL 61704-6394
(309) 662-7722
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.028635
IL
Other
Enumeration date
09/03/2013
Last updated
09/03/2013
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