Individual
DR. JARED W. JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
1122 E LINCOLN AVE, SUITE 210, ORANGE, CA 92865-1907
(714) 637-6700
(714) 637-5889
Mailing address
1710 PORT BARMOUTH PL, NEWPORT BEACH, CA 92660-5313
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
45578
CA
Other
Enumeration date
07/06/2007
Last updated
10/06/2008
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