Individual
DR. CHARLES BRYAN JAKOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4130 N 108TH AVE, SUITE 103-104, PHOENIX, AZ 85037-5774
(623) 772-9600
(623) 772-9601
Mailing address
4044 W ALEX LOOP, GLENDALE, AZ 85310-2444
(623) 209-4780
(623) 581-0793
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6266
AZ
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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