Organization
DENTAL PROFESSIONALS, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY L JACOBSEN DDS (PRESIDENT)
(515) 961-8411
Entity
Organization
Contact information
Practice address
200 N B ST, INDIANOLA, IA 50125-2429
(515) 961-8411
(515) 962-1810
Mailing address
200 N B ST, INDIANOLA, IA 50125-2429
(515) 961-8411
(515) 962-1810
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
07648J
IA
Other
Enumeration date
05/15/2008
Last updated
05/15/2008
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