Individual
BENJAMIN JAMES JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4141 GLASS RD NE, CEDAR RAPIDS, IA 52402-2512
(319) 393-0773
Mailing address
1201 ASTER DR APT 304, TIFFIN, IA 52340-4304
(515) 890-9605
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DDS-09912
IA
Other
Enumeration date
06/30/2021
Last updated
06/30/2021
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