Organization
BLAIN JACOBSON, DMD, A PROFESSIONAL DENTAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAIN JACOBSON (PRESIDENT)
(916) 772-4353
Entity
Organization
Contact information
Practice address
6910 DOUGLAS BLVD STE A, GRANITE BAY, CA 95746-6276
(916) 722-4353
Mailing address
6910 DOUGLAS BLVD STE A, GRANITE BAY, CA 95746-6276
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
56390
CA
Other
Enumeration date
04/15/2009
Last updated
04/15/2009
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