Individual
DR. ERIC STEFAN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1508 OXFORD DR, GEORGETOWN, KY 40324-9266
(502) 863-0880
Mailing address
1508 OXFORD DR, GEORGETOWN, KY 40324-9266
(502) 863-0880
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9750
KY
1223P0221X
Pediatric Dentistry
Primary
9750
KY
Other
Enumeration date
06/02/2016
Last updated
09/30/2020
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