Individual
DR. THOMAS E JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
514 LAKE ST, SITKA, AK 99835-7403
(907) 747-3203
Mailing address
514 LAKE ST, SITKA, AK 99835-7403
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AK 393
AK
Other
Enumeration date
08/04/2006
Last updated
07/08/2007
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