Individual
DR. JACOB MARLAN HASLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
448 E 5350 S STE C, OGDEN, UT 84405-5415
(801) 479-1700
Mailing address
448 E 5350 S, OGDEN, UT 84405-5414
(801) 479-1700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11747165-9922
UT
Other
Enumeration date
07/07/2020
Last updated
07/07/2020
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