Organization
JACOBSON FAMILY DENTISTRY P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRECIA T. JACOBSON DDS (CEO)
(218) 262-3730
Entity
Organization
Contact information
Practice address
704 E HOWARD ST, HIBBING, MN 55746-1744
(218) 161-3730
Mailing address
704 E HOWARD ST, HIBBING, MN 55746-1744
(218) 161-3730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D10897
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790802676
INDIVIDUAL NPI NUMBER
MN
Enumeration date
10/28/2008
Last updated
10/28/2008
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