| Gary B Jacobsen Dds, A Professional Dental Corporation | |
|
301 W Huntington Dr Suite 204 Arcadia CA 91007-3462 | |
| (626) 445-8048 | |
| (626) 445-8128 |
| Full Name | Gary B Jacobsen Dds, A Professional Dental Corporation |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 301 W Huntington Dr, Arcadia, California |
| Authorized Official Name and Position | Gary Bruce Jacobsen (DDS/PRESIDENT) |
| Authorized Official Contact | 6264458048 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gary B Jacobsen Dds, A Professional Dental Corporation 301 W Huntington Dr Suite 204 Arcadia CA 91007-3462 Ph: (626) 445-8048 | Gary B Jacobsen Dds, A Professional Dental Corporation 301 W Huntington Dr Suite 204 Arcadia CA 91007-3462 Ph: (626) 445-8048 |
| NPI Number | 1265841415 |
|---|---|
| Provider Enumeration Date | 08/12/2014 |
| Last Update Date | 08/12/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265841415 | NPI | - | NPPES |
| 1295885382 | Other | CA | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 26077 (California) | Primary |
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