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Organization
MATTHEW JACOBSEN PEDIATRIC DENTISTRY
Active
Organization
MATTHEW JACOBSEN PEDIATRIC DENTISTRY
Active
Other names
Jacobsen Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW VAUGHN JACOBSEN DDS (PEDIATRIC DENTIST)
(801) 589-3150
Entity
Organization
Contact information
Practice address
4019 W 12600 S STE 200, RIVERTON, UT 84096-7406
(801) 302-7938
Mailing address
4019 W 12600 S STE 200, RIVERTON, UT 84096-7406
(801) 302-7938
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
83203479923
UT
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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