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Organization

BRIAN J JACOBSEN DMD PC

Active
Other names
Jacobsen Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRIAN JAMES JACOBSEN D.M.D. (OWNER)
(509) 754-3262
Entity
Organization

Contact information

Practice address
103 1ST AVE SW, EPHRATA, WA 98823-1842
(509) 754-3262
(509) 754-4975
Mailing address
103 1ST AVE SW, EPHRATA, WA 98823-1842
(509) 754-3262
(509) 754-4975

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
60128176
WA
332BC3200X
Customized Equipment (DME)

Other

Enumeration date
09/16/2016
Last updated
09/16/2016
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