Organization
ERIC E JACOBSEN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JACOBSEN (OWNER)
(443) 562-5564
Entity
Organization
Contact information
Practice address
19502 MOLALLA AVENUE, SUITE 109-111, OREGON CITY, OR 97045
(443) 562-5564
Mailing address
17501 S JEAN DR, OREGON CITY, OR 97045-7833
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
03/01/2013
Last updated
03/13/2013
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