Individual
DR. KATHY JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1170 N GILBERT RD, SUITE 125, GILBERT, AZ 85234-2340
(480) 507-1807
(480) 813-5833
Mailing address
1170 N GILBERT RD, SUITE 125, GILBERT, AZ 85234-2340
(480) 507-1807
(480) 813-5833
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4743
AZ
Other
Enumeration date
04/17/2007
Last updated
07/08/2007
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