Individual
DR. MATTHEW JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MD
Contact information
Practice address
20 LONG CREEK DR, SOUTH PORTLAND, ME 04106-2425
(207) 772-3027
(207) 772-8641
Mailing address
20 LONG CREEK DRIVE, ORAL SURGERY ASSOCIATES PA, SOUTH PORTLAND, ME 04106
(207) 772-3027
(207) 772-8641
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4167
ME
Other
Enumeration date
11/02/2005
Last updated
07/02/2015
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