Individual
DR. MATTHEW VAUGHN JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4013 W 13400 S, RIVERTON, UT 84096-6410
(385) 210-1000
Mailing address
4013 W 13400 S, RIVERTON, UT 84096-6410
(385) 210-1000
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8320347-9922
UT
Other
Enumeration date
08/28/2012
Last updated
02/03/2021
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