Individual
MS. REGINA LYNNE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
9300 DEWITT LOOP RM O1.301B, FT BELVOIR, VA 22060-5285
(571) 263-6677
Mailing address
12920 LEATHERWOOD LN, WOODBRIDGE, VA 22192-8301
(571) 263-6677
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
0402205621
VA
Other
Enumeration date
02/11/2022
Last updated
02/11/2022
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