Individual
DR. CARL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1718 S 288TH ST, FEDERAL WAY, WA 98003-2981
(253) 839-4111
(253) 839-3573
Mailing address
1715 126TH AVE E, EDGEWOOD, WA 98372-6800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DE00003954
WA
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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