Individual
EGILL LARS JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
33 S ADDISON RD, SUITE 103, ADDISON, IL 60101-3868
(630) 941-3316
(630) 941-7020
Mailing address
210 W ELM PARK AVE, ELMHURST, IL 60126-3230
(630) 834-7617
(630) 941-7020
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
IL
Other
Enumeration date
11/08/2006
Last updated
07/08/2007
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