Organization
JACOBSON DENTAL CORP
Active
Other names
Children's Choice Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
KUSHBOO KUMAR (CREDENTIALING SPECIALIST)
(916) 877-7450
Entity
Organization
Contact information
Practice address
932 ADMIRAL CALLAGHAN LN, VALLEJO, CA 94591-3680
(707) 794-2020
(844) 534-8464
Mailing address
1420 ROCKY RIDGE DR STE 320, ROSEVILLE, CA 95661-2835
(916) 877-7450
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/28/2025
Last updated
03/28/2025
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