Organization
PETER W JACOBSEN DDS PLLC
Active
Other names
Maple Valley Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE S CIELO (MANAGER)
(425) 413-8525
Entity
Organization
Contact information
Practice address
27016 MAPLE VALLEY BLK DIAMOND RD SE, MAPLE VALLEY, WA 98038
(425) 413-8525
(425) 413-8599
Mailing address
27016 MAPLE VALLEY BLK DIAMOND RD SE, MAPLE VALLEY, WA 98038
(425) 413-8525
(425) 413-8599
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00005267
WA
Other
Enumeration date
11/07/2006
Last updated
08/01/2008
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