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Individual

DR. JACOB ANDERSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
3208 N ACADEMY BLVD STE 140, COLORADO SPRINGS, CO 80917-5111
(719) 301-5300
Mailing address
3208 N ACADEMY BLVD STE 140, COLORADO SPRINGS, CO 80917-5111

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00203252
CO

Other

Enumeration date
07/12/2017
Last updated
07/12/2017
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