Individual
DR. ROGER ARTHUR JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
15 W MURDOCK AVE, OSHKOSH, WI 54901
(920) 231-0060
Mailing address
15 W MURDOCK AVE, OSHKOSH, WI 54901
(920) 231-0060
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5001210010
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33682300
—
WI
Enumeration date
09/15/2006
Last updated
07/08/2007
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