Individual
DR. STEVEN ROBERT JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4801 HWY 61, #300, WHITE BEAR LAKE, MN 55110
(651) 429-2299
(651) 429-6630
Mailing address
4801 HWY 61, #300, WHITE BEAR LAKE, MN 55110
(651) 429-2299
(651) 429-6630
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
9043
MN
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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