Individual
RAECHEL JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
449 S 1ST ST, EVANSVILLE, WI 53536-1394
(608) 882-4338
Mailing address
415 HIGHLAND PARK AVE, CLINTON, WI 53525-9795
(608) 302-5484
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
100231315
WI
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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